Transplants from donors with hepatitis C may be a safe option for those awaiting new hearts – a major development in curbing the nationwide organ shortage, according to new research.
Patients who received heart transplants from donors who had hepatitis C saw similar outcomes a year after surgery as those whose donors did not have hepatitis C. Researchers compared one-year survival, organ rejection, dialysis and incidence of stroke.
The study, published in the Journal of the American Heart Association, examined 7,889 U.S. adults who received heart transplants between 2016 and 2018. Slightly more than 4%, or 343, received heart transplants from donors with hepatitis C.
“We are encouraged by these results and believe this is a landmark change in our ability to better meet the demand for heart transplantation by increasing the donor supply,” McGowan Institute for Regenerative Medicine affiliated faculty member Arman Kilic, MD, lead study author, said in a news release. He is an Assistant Professor of Cardiothoracic Surgery, the Director, Surgical Quality and Analytics, Cardiac Surgery, and Co-Director, Center for Cardiovascular Outcomes and Innovation, in the Department of Cardiothoracic Surgery at the UPMC Heart and Vascular Institute. “It is our hope that more centers will use hepatitis C-positive donors for heart transplantation.”
McGowan Institute for Regenerative Medicine affiliated faculty member Thomas Gleason, MD, the Ronald V. Pellegrini Endowed Professor of Cardiothoracic Surgery and Chief, Division of Cardiac Surgery of the University of Pittsburgh School of Medicine, and the Co-Director of the Heart and Vascular Institute at UPMC, is a co-author on the study. He is also Director of the Center for Thoracic Aortic Disease and Co-Director of the Center for Heart Valve Disease, and he is a member of the Center for Vascular Remodeling and Regeneration at Pitt.
Hepatitis C, though curable in most cases, can be a debilitating illness. It is a viral liver infection that spreads through contact with contaminated blood, by way of shared needles and from mother to infant during pregnancy and delivery. Because it can be treated, there has been an increase in organ donors with hepatitis C as the need for heart transplants continues to exceed the supply.
In the new study, researchers found similar survival rates regardless of whether patients received a heart from a donor with or without hepatitis C – 90% compared to 91%, respectively. There was also little difference between the two groups when comparing the rates of stroke, drug-treated organ rejection, and kidney dialysis to remove toxins from the blood.
More than 6 million people in the U.S. have heart failure and more than 900,000 new cases are diagnosed each year. It occurs when other types of heart disease weaken the heart until it is unable to pump blood effectively throughout the body. Although lifestyle changes and medications can help manage mild heart failure, severe cases may require a heart transplant.
The study did have limitations. For example, researchers did not collect information about the type of hepatitis C infection each donor had or past treatments they received. The study also did not report whether transplant recipients developed the infection.
Abstract (Outcomes of adult heart transplantation using hepatitis C–positive donors. Arman Kilic, Gavin Hickey, Michael Mathier, Ibrahim Sultan, Thomas G. Gleason, Ed Horn, and Mary E. Keebler. Journal of the American Heart Association, originally published 8 Jan 2020.)