Impact of hepatitis C infection on outcomes after heart transplantation

• Published in: Transplantation Vol. 88; no. 9; p. 1137
• Main Authors: Fong, Tse-Ling, Hou, Linda, Hutchinson, Ian V, Cicciarelli, James C, Cho, Yong W
• Format: Journal Article
• Language: English
• Published: United States 15.11.2009
• Subjects: Creatinine - blood; Diabetes Mellitus - epidemiology; Graft Rejection - epidemiology; Heart Transplantation - adverse effects; Heart Transplantation - mortality; Heart Transplantation - physiology; Hepatitis C - epidemiology; Hepatitis C - mortality; Humans; Incidence; Postoperative Complications - epidemiology; Prevalence; Recurrence; Retrospective Studies; Survival Rate; Treatment Outcome
• ISSN: 1534-6080
• DOI: 10.1097/tp.0b013e3181bd3e59

Prevalence of hepatitis C infection (HCV) among heart transplant (OHT) recipients ranges from 7% to 18%. Despite the paucity of data regarding the outcomes of heart transplant recipients who are HCV positive before transplant, many transplant centers are declining to perform OHT in HCV-seropositive patients. We assessed the clinical outcome of HCV-seropositive compared with HCV-seronegative heart transplant recipients using the Organ Procurement and Transplant Network/the United Network for Organ Sharing database. Between January 1, 2000, and December 31, 2005, 224 HCV-seropositive and 10,406 HCV-seronegative recipients who received HCV-seronegative donor organs were identified. Overall patient survival rates of HCV-seropositive recipients were significantly lower than those of HCV-seronegative recipients (84.8% at 1 year, 77.1% 3 years, 68.9% 5 years for HCV-seropositive group vs. 87.9% at 1 year, 80.7% 3 years, and 74.1% 5 years for HCV-negative recipients, log rank P=0.036). However, adjusted relative risk of recipient HCV-seropositive versus HCV-seronegative status did not reach to statistical significance level (relative risk=1.23 with P=0.087) after adjusting for other donor and recipient factors. Causes of death among HCV-seropositive and HCV-seronegative groups were similar. Cumulative incidence of an acute rejection episode in the first year after transplantation among HCV-seropositive recipients was 35.7% versus 32.6% HCV-seronegative recipients (P=0.32). A more rational approach should be developed for the management of HCV-seropositive heart transplant candidates. Carefully selected HCV-seropositive patients should not be excluded from OHT.