Disparities in Utilization of Hepatitis C Virus Positive Hearts for Transplantation

Purpose The goal of this study was to utilize data from the United Network of Organ Sharing (UNOS) database to assess disparities in utilization of hepatitis C virus (HCV)+ hearts for transplant. Methods We obtained de-identified data from UNOS from 2/1/16-1/31/18. We divided these donors into three categories: HCV -, HCV antibody+/ nucleic acid test negative (HCV+/ NAT-) and HCV NAT+. Utilization rate was calculated as a percentage of number of hearts successfully transplanted / number of donors recovered. Organ quality was indirectly assessed using donor age and ejection fraction (EF). Differences in means were assessed via ANOVA and categorical variables via chi2 analysis. Results Among 20,442 donors, 18,948 were HCV-, 511 were HCV+ NAT- and 983 were HCV NAT+. The overall mean utilization rate of HCV- hearts was 33.7% (standard deviation, SD 1.74) whereas the HCV+/NAT- was 11.6% (SD 7.15) and NAT+ was 7.1% (SD 4.94, p 55% was similar (HCV- 93.1% vs. HCV+/NAT- 89.8% vs. NAT+ 97.3%, p=0.73). Proportion of transplanted hearts with donor age Conclusion We note disparities at a national, regional, and OPO level in the utilization of hearts for transplantation based on HCV status. Given early outcomes of HCV+ heart transplant, we believe there is opportunity to increase heart transplantation rates in the US.