Hepatitis C and heart transplantation: An update

Area of Science:

• Cardiology
• Infectious Diseases
• Transplantation Medicine

Background:

• Historically, hepatitis C virus (HCV) infection posed a significant concern for heart transplantation outcomes.
• Concerns regarding donor and recipient HCV status limited transplant frequency and organ utilization.

Purpose of the Study:

• To review the evolving landscape of heart transplantation in the context of HCV infection.
• To assess the impact of direct-acting antivirals (DAAs) and improved diagnostics on transplant practices and outcomes.

Main Methods:

• Literature review examining pre-DAA and DAA eras of heart transplantation.
• Analysis of outcomes for HCV-infected recipients and use of HCV-positive donor organs.

Main Results:

• Direct-acting antiviral therapies have transformed HCV management, removing it as a transplant barrier.
• The use of HCV-positive organs for both HCV-infected and uninfected recipients has significantly increased.
• Short-term survival data in the DAA era suggest parity between HCV-infected and uninfected heart transplant recipients.

Conclusions:

• HCV infection is no longer an absolute contraindication for heart transplantation.
• Increased utilization of HCV-positive donor organs is supported by encouraging preliminary outcomes.
• Further long-term safety data are required to fully optimize protocols for this practice.