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Updated: Jun 12, 2025
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Transplantation Outcomes in Hepatitis C Virus-Positive Donor Hearts After Circulatory Death
Francesco Castagna1, Charlotte Andersson1, Mandeep R Mehra1
1Center for Advanced Heart Disease, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Insights
Hepatitis C virus (HCV)-positive hearts from circulatory death donors show similar outcomes to brain death donors. This finding supports expanding the use of HCV-positive hearts in organ transplantation.
Area of Science:
- Transplantation immunology
- Organ procurement
- Hepatitis C virus research
Background:
- Hepatitis C virus (HCV)-positive hearts from donation after brain death (DBD) donors are safe and effective.
- Outcomes of HCV-positive hearts from donation after circulatory death (DCD) donors are not well-established.
- DCD procurement involves unique perfusion strategies and temperature fluctuations.
Purpose of the Study:
- To compare clinical outcomes of HCV-positive hearts from DCD versus DBD donors.
- To assess the safety and efficacy of HCV-positive hearts in DCD transplantation.
- To inform organ offer acceptance criteria for HCV-positive donors.
Main Methods:
- Retrospective analysis of United Network for Organ Sharing (UNOS) registry data.
- Comparison of clinical outcomes between DCD and DBD donor groups.
- Evaluation of allograft rejection, early, and 1-year survival rates.
Main Results:
- No significant difference in treated allograft rejection rates between DCD and DBD groups.
- Similar early and 1-year survival rates for recipients of HCV-positive hearts from both donor types.
- Clinical outcomes do not differ based on organ recovery source (DCD vs. DBD).
Conclusions:
- HCV-positive hearts recovered from DCD donors demonstrate comparable outcomes to those from DBD donors.
- Organ recovery source should not bias organ offer acceptance from HCV-positive donors.
- Further long-term outcome data are needed for comprehensive evaluation.
Abstract:
Although the use of hepatitis C virus (HCV)-positive hearts has been shown to be safe and effective among donors with donation after brain death (DBD), it remains unknown whether such organs recovered after circulatory death (DCD) have similar outcomes. In contradistinction to recovery from DBD using cold static organ storage, DCD procurement processes typically use normothermic-perfusion transport strategies that necessitate the use of a large volume of donor blood and involve exposure to temperatures oscillating between cold to dominantly normothermic conditions. We performed a retrospective analysis of United Network for Organ Sharing (UNOS) registry data in the United States and found that clinical outcomes do not differ with respect to rates of treated allograft rejection, early and 1-year survival. Ideally, the organ-recovery source should not result in a bias in organ-offer acceptance from HCV-positive donors, although long-term outcome data are yet unavailable.
