Demographics and Utilization of Hepatitis C Hearts: A Single Center Experience

PurposeSince the advent of direct acting antiviral therapies as a cure for hepatitis C virus (HCV), the use of HCV nucleic acid test (NAT) positive donors in adult heart transplantation is increasing. The degree to which HCV NAT+ donor characteristics may impact donor selection remains unclear. We sought to explore the demographics and organ acceptance and transplantation rates of HCV NAT+ donor offers to our center, relative to those of other donor offers.MethodsWe used the United Network of Organ Sharing (UNOS) DonorNet database to evaluate 1,000 consecutive primary donor offers made to our center between January 1, 2018 and March 3, 2019. Statistical analysis was performed using ANOVA tests.ResultsOf 1,000 donor offers evaluated by our center, 238 were HCV antibody (Ab) positive of which 177 were HCV NAT positive. Compared to other donors, HCV NAT+ donors tended to be younger, male, and to die more often from drug overdose. Despite procurement teams having to travel longer distances to recover them, HCV NAT+ donors had higher rates of organ acceptance and ultimate transplantation relative to other donors.ConclusionFavorable demographic characteristics of HCV NAT+ donors are associated with higher rates of organ acceptance and transplantation at our center, despite longer procurement distances. Especially given the promising early outcomes among recipients of these donors, we anticipate that the rate of HCV NAT+ donor utilization will soon eclipse that of HCV naïve donor utilization nationwide. Since the advent of direct acting antiviral therapies as a cure for hepatitis C virus (HCV), the use of HCV nucleic acid test (NAT) positive donors in adult heart transplantation is increasing. The degree to which HCV NAT+ donor characteristics may impact donor selection remains unclear. We sought to explore the demographics and organ acceptance and transplantation rates of HCV NAT+ donor offers to our center, relative to those of other donor offers. We used the United Network of Organ Sharing (UNOS) DonorNet database to evaluate 1,000 consecutive primary donor offers made to our center between January 1, 2018 and March 3, 2019. Statistical analysis was performed using ANOVA tests. Of 1,000 donor offers evaluated by our center, 238 were HCV antibody (Ab) positive of which 177 were HCV NAT positive. Compared to other donors, HCV NAT+ donors tended to be younger, male, and to die more often from drug overdose. Despite procurement teams having to travel longer distances to recover them, HCV NAT+ donors had higher rates of organ acceptance and ultimate transplantation relative to other donors. Favorable demographic characteristics of HCV NAT+ donors are associated with higher rates of organ acceptance and transplantation at our center, despite longer procurement distances. Especially given the promising early outcomes among recipients of these donors, we anticipate that the rate of HCV NAT+ donor utilization will soon eclipse that of HCV naïve donor utilization nationwide.