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Hepatitis C–Positive Donors in Cardiac Transplantation: Problems and Opportunities

  • Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A Hasan, Section Editor)
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Abstract

Purpose of Review

With the growing need for donor hearts and longer transplant waiting lists, there is a growing interest in expanding the donor pool by reconsidering previously excluded donor candidates. There has been an increase in solid organ availability due to drug overdose deaths in the setting of the recent opioid epidemic. However, these donors often have transmissible infections such as hepatitis C. In this review, we discuss the challenges associated with heart transplantation from hepatitis C–infected donors as well as the recent advancements that are making the use of these organs possible.

Recent Findings

With the introduction and widespread use of nucleic acid testing (NAT), the ability to distinguish viremic donors and those that have cleared the virus has become a reality. In addition, with the emergence of direct antiviral agents, there is an increase in data showing the short-term outcomes and success of hepatitis C treatment for recipients of viremic donor hearts.

Summary

As techniques to distinguish donor hepatitis C infection status and successful treatments emerge, the percentage of accepted hepatitis C donor hearts is increasing. A number of studies showing success with hepatitis C organ transplants present a promising new avenue for organ procurement essential to meet the increasing demand for donor hearts.

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Author notes

  1. Yogita Rochlani and Karim Diab contributed equally to this work.

Authors and Affiliations

  1. Division of Cardiology, Montefiore Medical Center and Albert Einstein College of Medicine, 3400 Bainbridge Ave. 7th floor, Bronx, NY, USA

    Yogita Rochlani & Ulrich P. Jorde

  2. Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA

    Karim Diab

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Correspondence to Ulrich P. Jorde.

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Rochlani, Y., Diab, K. & Jorde, U.P. Hepatitis C–Positive Donors in Cardiac Transplantation: Problems and Opportunities. Curr Heart Fail Rep 17, 106–115 (2020). https://doi.org/10.1007/s11897-020-00466-y

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