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Cardiac transplantation from non-viremic hepatitis C donors.
- Source :
-
Journal of Heart & Lung Transplantation . Oct2018, Vol. 37 Issue 10, p1254-1260. 7p. - Publication Year :
- 2018
-
Abstract
- BACKGROUND Hepatitis C (HCV) donors are rarely used for cardiac transplantation due to historically poor outcomes. In 2015, nucleic acid testing (NAT) for viral load was added to the routine work-up of organ donors, allowing for the distinction between subjects who remain viremic (HCV Ab+/NAT+) and those who have cleared HCV and are no longer viremic (HCV Ab+/NAT–). The American Society of Transplantation recently recommended that HCV Ab+/NAT– donors be considered non-infectious and safe for transplantation. We present our initial experience with such donors. METHODS All patients were counseled regarding donor HCV antibody (Ab) and NAT. Transplant recipients were tested post-transplant at 1 week and at 1, 3, and 6 months for HCV seropositivity and viremia. We also analyzed the UNOS database to determine the potential impact of widespread acceptance of HCV Ab+/NAT– organs. RESULTS Fourteen HCV Ab‒ subjects received hearts from HCV Ab+/NAT– donors in 2017. Over a median follow-up of 256 (192 to 377) days, 3 patients developed a reactive HCV Ab, yet none had a detectable HCV viral load during prospective monitoring at any time. Analysis of the UNOS database for the calendar year 2016 revealed that only 7 (3%) of 220 HCV Ab+/NAT– donors were accepted for heart transplantation. CONCLUSIONS We have demonstrated the feasibility of utilizing HCV Ab+/NAT– donors for cardiac transplantation without recipient infection. A small percentage of recipients developed HCV Ab without evidence of viremia, possibly consistent with a biological false reactive test, as has been seen in other settings. Large-scale validation of our data may have a significant impact on transplantation rates. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ORGAN donors
*HEPATITIS C
*HEART transplantation
*VIREMIA
*NUCLEIC acids
*VIRAL load
Subjects
Details
- Language :
- English
- ISSN :
- 10532498
- Volume :
- 37
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Journal of Heart & Lung Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 132149544
- Full Text :
- https://doi.org/10.1016/j.healun.2018.06.012