Increased early Acute Cellular Rejection Events in Hepatitis C Positive Heart Transplantation

ABSTRACT Background : Increased utilization of hepatitis C positive (HCV) donors has increased transplantation rates. However, high levels of viremia have been documented in recipients of viremic donors. There is a knowledge gap in how transient viremia may impact acute cellular rejections. Methods : In this study, 50 subjects received hearts from either viremic or non-viremic donors. The recipients of viremic donors were classified as NAT+ group and remaining NAT-. All patients were monitored for viremia levels. Endomyocardial biopsies were performed through 180 days evaluating the incidence of acute cellular rejections (ACR). Results : Fifty HCV naive recipients received hearts between 2018 t0 2019. Twenty two (44%) transplants from viremic donors all developed viremia at mean 7.2±0.2days. At that time, Glecaprevir/Pibrentasvir (GLEP/PIB) was initiated. In the viremia period ( Conclusions : Transient levels of viremia contributed to a higher rates and severity of ACRs. Further investigation into the mechanisms of early immune activation in NAT + recipients is required.