Using hepatitis C and B virus–infected donor organs for pediatric heart transplantation

Abstract

Objective: High-risk donors for patients with end-stage cardiac or pulmonary disease awaiting transplantation represent an opportunity for access to more organs and therefore can significantly decrease the waiting list mortality. The objective of this study is to investigate the use of hepatitis B virus core antibody positive or hepatitis C virus seropositive donors for pediatric heart transplantation.Methods: Data were reviewed from the United Network of Organ Sharing database (June 2008 to June 2015). A total of 3 hepatitis C seropositive and 9 hepatitis B core antibody positive donor hearts were identified for transplantation. Factors of age, underlying diagnosis, transplant year, extracorporeal membrane oxygenation, inotrope support, hepatitis C virus serostatus, and hepatitis B virus surface antigen status were used for 2 separate propensity score models. Standardized difference was evaluated for these variables before and after match. Survival was compared between the matched cohorts.Results: Post-transplant graft survivals for recipients of hepatitis C virus positive donors and hepatitis B virus core antibody positive donors were similar to matched recipients of hepatitis C virus negative and hepatitis B virus core antibody negative donors, respectively.

Heart Transplantation From Hepatitis C–Positive Donors in the Era of Direct Acting Antiviral Therapy: A Comprehensive Literature Review

“…After removing duplicates, 78 publications were screened and 34 met inclusion criteria. After reading the papers, 14 publications were excluded—3 were in a pediatric population 30 and the other 11 had insufficient data for analysis.…”

Successful use of a hepatitis C viremic donor in pediatric bilateral lobar lung transplantation

“… 1 However, there have been no reports to date regarding the use of HCV NAT–positive donors for pediatric solid-organ transplantation except for a report regarding usage of HCV seropositive heart to children. 4 Our case highlights the safety and feasibility of our protocol for pediatric LT recipients.…”

An integrated program to expand donor utilization in pediatric heart transplantation: Case report of successful transplant with multiple donor risk factors

“…Ratzi et al described the post-transplant outcomes of pediatric heart transplant recipients who received an HCV-positive donor. 6 Although this study was limited by the small study cohort, the post-transplant graft survival for recipients of HCV-positive donors was similar to those who had an HCV-negative donor (5-year survival: 67% vs 88%, p = .48). In adult transplantation, the number of centers performing heart transplantation using HCV+ donors have increased significantly in the last few years due to the introduction of direct acting antiviral drugs.…”