Use of Donor HCV NAT Positive Hearts: Expanding the Donor Pool?

Purpose Use of HCV NAT+ donor hearts may aid in expanding the donor pool. However, limited single center data exist. We aim to assess the short-term impact of use of HCV NAT+ hearts in a national dataset. Methods 8256 HT patients with reported donor HCV NAT status were identified from UNOS (2010-2018), of which 88 received an HCV NAT positive (HCV+) donor. Exclusions included age proportional hazard regression analysis (adjusted for age, sex, diabetes , race, ischemic time , dialysis, life support & HLA mismatch) was performed. Results 88 pts underwent successful HT with HCV NAT positive donors. Predominant etiologies did not differ (p=0.169). During study period, 826 pts died post HT (NAT + vs -: 9.1 vs 10.0, p=0.77). Crude 1, 6 & 12 m post-HT survival was NAT+ [96, 91, 82%] vs NAT- [97, 93, 91%] (log-rank, p Multivariate analysis yielded a hazard ratio of 1.45 (CI 0.65-3.28) comparing NAT+ to NAT- recipients. Conclusion Short-term survival is similar between HCV NAT+ versus NAT- HT recipients. This data is promising and represents a step forward in expanding the donor pool. Further study is warranted to assess the long-term impact of this donor population.