- 11 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. 2 Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. 3 Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. 4 Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Background: The use of hepatitis C virus (HCV) positive donors has expanded the donor pool for orthotopic heart transplantation (OHT). This study evaluated center-level trends and utilization of HCV+ donors for OHT.
Methods: Data were extracted from the Scientific Registry of Transplant Recipients on adults (≥18 years) undergoing OHT between January 1, 2016 and December 31, 2019. Centers performing <10 OHTs during the study period were excluded. Donor utilization rates were evaluated at the center level. Center-level characteristics were compared between centers performing HCV+ donor HCV- recipient OHTs and those not utilizing HCV+ donors for HCV- recipients.
Results: A total of 10,134 patients underwent OHT, including 613 (6.05%) HCV+ donors transplanted into HCV- recipients. The number of HCV+ OHTs increased from 15/2512 (0.60%) in 2016 to 285/2490 (11.45%) in 2019 (p<0.001). In 2016, among 105 centers performing OHTs, 7 (6.67%) utilized HCV+ donors compared to 2019 during which 55 (52.89%) of 104 centers utilized HCV+ donors (p<0.001). In total, 57 of 107 (53.27%) centers utilized HCV+ donors during the study period. Centers utilizing HCV+ donors had higher overall donor utilization rates (7,376/24,378 [30.26%] vs 3,463/15,335 [22.58%], p<0.001) and were higher volume as compared to nonutilizing centers (mean annual OHT volume 30.72±1.21 vs 16.2±1.40, p<0.001).
Conclusions: Although the use of HCV+ donors for OHT is rapidly expanding in the United States, almost half of transplant centers remain nonutilizers. Broader education and implementation of HCV+ donor protocols may be important in expanding OHT to more patients with end-stage heart failure.Supplemental Visual Abstract; http://links.lww.com/TP/C138.