Utilization rates and clinical outcomes of hepatitis C positive donor hearts in the contemporary era

Madan, Shivank; Patel, Snehal R.; Rahgozar, Kusha; Saeed, Omar; Murthy, Sandhya; Vukelic, S.; Sims, Daniel B.; Shin, J.; Goldstein, Daniel J.; Jorde, Ulrich P.

doi:10.1016/j.healun.2019.06.023

Cited by 40 publications

(45 citation statements)

References 25 publications

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“…Our center reports excellent outcomes with no significant differences found between recipients whom received viremic (NAT+/Ab + or NAT+/Ab−) vs non‐viremic (NAT−/Ab− or NAT−/Ab+) donor hearts. By comparison to compiled studies, 23 this is one of the larger series of heart transplants performed utilizing hepatitis C viremic donors. Multiple centers including ours have demonstrated when transplanting hearts from viremic donors into HCV naive recipients, the result is a rapid rise in viral titers in the early post‐operative course 8,9 .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the Treatment with Glecaprevir/Pibrentasvir following heart transplantation utilizing hepatitis C viremic donors

Reyentovich

Gidea

Smith

et al. 2020

Clinical Transplantation

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Section: Discussionmentioning

confidence: 99%

Outcomes of the Treatment with Glecaprevir/Pibrentasvir following heart transplantation utilizing hepatitis C viremic donors

Reyentovich

Gidea

Smith

et al. 2020

Clinical Transplantation

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“…Limited short-term data from liver, (340,357,390,391) kidney, (358,(378)(379)(380)(390)(391)(392)(393)(394) heart, (359,373,390,395) and lung (359,374) transplant programs performing solid organ transplantations involving HCV-viremic donors and HCV-negative recipients are encouraging. However, the overall number of published cases is limited, and treatment approaches varied.…”

Section: Recommendations For Daa Therapymentioning

confidence: 99%

Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

2020

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“…One type of shared cost is the copayment, or "copay," which is a fixed amount an individual pays for a specific service or prescription medication. 2 Since the advent of direct-acting antiviral (DAA) treatment, 3 there has been an increase in the use of HCV-V organs for transplant, [4][5][6][7][8] mostly within the clinical trial setting but also as part of real-world clinical practice protocols in which patients are responsible for the cost of DAA therapy, 9,10 which can be considerable. 11 Recent reports suggest excellent short-term outcomes with use of HCV-V organ transplantation.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Post‐transplant survey to assess patient experiences with donor‐derived HCV infection

Prakash

Ramirez‐Sanchez

Ramirez

et al. 2020

Transplant Infectious Dis

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Background: Despite increased utilization of hepatitis C virus-infected (HCV+) organs for transplantation into HCV-uninfected recipients, there is lack of standardization in HCV-related patient education/consent and limited data on financial and social impact on patients. Methods: We conducted a survey on patients with donor-derived HCV infection at our center transplanted between 4/1/2017 and 11/1/2019 to assess: why patients chose to accept HCV+ organ(s), the adequacy of their pre-transplant HCV education and informed consent process, financial issues related to copays after discharge, and social challenges they faced. Results: Among 49 patients surveyed, transplanted organs included heart (n = 19), lung (n = 9), kidney (n = 11), liver (n = 4), heart/kidney (n = 4), and liver/kidney (n = 2). Many recipients accepted an HCV-viremic (HCV-V) organ due to perceived reduction in waitlist time (n = 33) and/or trust in their physician's recommendation (n = 29). Almost all (n = 47) felt that pre-transplant education and consent was appropriate. Thirty patients had no copay for direct-acting antivirals (DAA) for HCV, including 21 with household income <$20 000; seven had copays of <$100 and one had a copay >$1000. Two patients reported feeling isolated due to HCV infection and eight reported higher than anticipated medication costs. Patients' biggest concern was potential HCV transmission to partners (n = 18) and family/friends (n = 15). Overall almost all (n = 47) patients reported a positive experience with HCV-V organ transplantation. Conclusion: We demonstrate that real-world patient experiences surrounding HCV-V organ transplantation have been favorable. Almost all patients report comprehensive HCV-related pre-transplant consent and education. Additionally, medication costs and social isolation/exclusion were not barriers to the use of these organs.

show abstract

Utilization rates and clinical outcomes of hepatitis C positive donor hearts in the contemporary era

Cited by 40 publications

References 25 publications

Outcomes of the Treatment with Glecaprevir/Pibrentasvir following heart transplantation utilizing hepatitis C viremic donors

Outcomes of the Treatment with Glecaprevir/Pibrentasvir following heart transplantation utilizing hepatitis C viremic donors

Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

Post‐transplant survey to assess patient experiences with donor‐derived HCV infection

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