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Acceptable recipient outcomes with the use of hearts from donors with hepatitis-B core antibodies

Sean P Pinney1, Faisal H Cheema, Kimmarie Hammond

  • 1Division of Circulatory Physiology, New York Presbyterian Hospital, MHB5-435, 177 Fort Washington Avenue, New York, New York 10032, USA. sp461@columbia.edu

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|January 18, 2005
PubMed

Insights

Transplanting hearts from hepatitis-B core antibody-positive donors is safe and expands the donor pool. Viral transmission risk is low, even without antiviral prophylaxis, making these organs a viable option.

Area of Science:

  • Cardiology
  • Transplantation immunology
  • Hepatology

Background:

  • Donor organ shortage limits cardiac transplantation.
  • Hearts from hepatitis-B core antibody-positive donors are typically avoided due to transmission concerns.
  • This study evaluates the safety of using these donor hearts.

Purpose of the Study:

  • To determine the safety of transplanting hearts from donors with hepatitis-B core antibodies.
  • To assess the risk of viral transmission in recipients.
  • To evaluate the impact on post-transplant survival.

Main Methods:

  • Retrospective review of donor and recipient charts.
  • Analysis of 541 heart transplantations performed between January 1997 and December 2002.
  • Comparison of outcomes in recipients of hearts from core-antibody-positive donors versus the general transplant population.

Main Results:

  • Thirty-three patients received hearts from core-antibody-positive donors.
  • Only one patient (without prophylaxis) experienced donor-transmitted hepatitis B infection.
  • Hepatitis B seroconversion occurred in two patients without evidence of infection; none of the 5 patients on lamivudine prophylaxis developed transmitted hepatitis.
  • Post-transplant survival was comparable to the overall transplant cohort.

Conclusions:

  • Transplantation of hearts from hepatitis-B core antibody-positive donors carries a low risk of viral transmission.
  • The use of antiviral prophylaxis (lamivudine) appears to mitigate transmission risk.
  • Consideration of these donor hearts is safe and can help increase the availability of organs for cardiac transplantation.
Abstract

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