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World J Transplant. Dec 18, 2022; 12(12): 394-404
Published online Dec 18, 2022. doi: 10.5500/wjt.v12.i12.394
Review of heart transplantation from hepatitis C-positive donors
Palak Patel, Nirav Patel, Fahad Ahmed, Jason Gluck
Palak Patel, Department of Cardiology, West Roxbury VA Center, West Roxbury, MA 02132, United States
Nirav Patel, Department of Cardiology, University of Connecticut, Harford Hospital, Hartford, CT 06102, United States
Nirav Patel, Department of Cardiology, University of California, CA 90065, United States
Fahad Ahmed, Department of Internal Medicine, Hartford Hospital, Hartford, CT 06106, United States
Jason Gluck, Advanced Heart Failure, Hartford Hospital, Hartford, CT 06102, United States
Author contributions: Patel P and Patel N contributed to performing the research; Ahmed F contributed to writing the paper; Patel N and Gluck J contributed to designing the research; Patel P, Patel N, and Gluck J contributed to.
Conflict-of-interest statement: All the authors declare having no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jason Gluck, DO, FACC, Attending Doctor, Chief Physician, Advanced Heart Failure, Hartford Hospital, 85 Seymour Street, Hartford, CT 06102, United States. jason.gluck@hhchealth.org
Received: September 9, 2022
Peer-review started: September 9, 2022
First decision: October 21, 2022
Revised: November 3, 2022
Accepted: November 22, 2022
Article in press: November 22, 2022
Published online: December 18, 2022
Processing time: 98 Days and 6.3 Hours
Abstract

Significant scarcity of a donor pool exists for heart transplantation (HT) as the prevalence of patients with end-stage refractory heart failure is increasing exceptionally. With the discovery of effective direct-acting antiviral and favorable short-term outcomes following HT, the hearts from hepatitis C virus (HCV) patient are being utilized to increase the donor pool. Short-term outcomes with regards to graft function, coronary artery vasculopathy, and kidney and liver disease is comparable in HCV-negative recipients undergoing HT from HCV-positive donors compared to HCV-negative donors. A significant high incidence of donor-derived HCV transmission was observed with great success of achieving sustained viral response with the use of direct-acting antivirals. By accepting HCV-positive organs, the donor pool has expanded with younger donors, a shorter waitlist time, and a reduction in waitlist mortality. However, the long-term outcomes and impact of specific HCV genotypes remains to be seen. We reviewed the current literature on HT from HCV-positive donors.

Keywords: Heart transplant, Hepatitis C-positive donors, Direct-acting antiviral, Coronary allograft vasculopathy, Allograft rejection

Core Tip: Given the favorable preliminary data and ongoing opioid epidemic, the utilization of hepatitis C virus-positive hearts is on the rise, which is aiding in the closure of the gap between heart transplantation candidates and donors. Additionally, with future studies evaluating long-term outcomes and standardization of direct-acting antiviral therapy, more transplant centers will accept hepatitis C virus-positive organs.