Acceptance of HCV-Positive Donor Hearts Improves Organ Acceptance Selectivity: Single Center Experience

Purpose Due to the shortage of donor hearts in the United States, it is essential we continuously evaluate strategies aimed at increasing donor organ availability. Our institution sought to expand the cardiac donor pool by utilizing hepatitis C virus (HCV) positive donor hearts. In a single center retrospective study, we examined the quality of HCV-positive donor hearts as compared to HCV-negative donor hearts. Methods Between October 2015 and October 2018, 111 cardiac transplants occurred at our center. 23 of these organs came from HCV-positive donors. Baseline donor characteristics were examined for all cardiac transplants and donor quality between HCV-positive and HCV-negative donors compared. Results Twenty-three (20%) of patients received HCV-positive hearts. On average the HCV-positive donors were accepted by our program at lower match sequence numbers than HCV-negative donors (sequence 12±17 versus 64±103, p 0.05 for all comparisons) was seen between HCV-positive and HCV-negative donor hearts. Acceptance of HCV-positive donor hearts facilitated dual-organ transplantation with 3 (13%) patients receiving dual organs as compared to only 4 (4%) in the HCV-negative recipient group. All patients who received HCV-positive donor hearts were alive at the time of this analysis compared to 89% in the HCV-negative group. Conclusion In this single-center study, patients who underwent HCV-positive donor heart transplantation received hearts at lower sequence numbers with a trend toward lower donor age. Short-term outcomes with HCV-positive donor hearts are favorable. Acceptance of HCV-positive donor hearts represents a potential approach to safely expand the available donor pool.