1 From the Department of Medicine, Division of Gastroenterology and Hepatobiliary Disease.
2 Department of Medicine, Division of Infectious Diseases.
3 Department of Medicine, Division of Cardiology.
4 Department of Surgery, Cardiothoracic Surgery.
5 Department of Surgery, Division of Transplant Hepatology, New York Medical College, Westchester Medical Center, Valhalla, NY.
Multiple strategies have been implemented to increase the donor pool to avoid transplant wait-list mortality. The approval of highly effective direct-acting antiviral regimens for the treatment of hepatitis C virus (HCV) has enabled expansion of the donor pool by allowing the transplantation of organs from HCV-viremic donors to HCV-negative recipients. Multiple centers have recently published data on outcomes of heart transplantation from HCV-viremic heart donors to HCV-negative recipients, with acceptable posttransplant outcomes. However, areas of uncertainty remain, particularly in the long-term risks of intentional HCV transmission, as well as the possibility that sustained virologic response may not be achieved. In this article, we review the literature illustrating both the risks and benefits of transplantation of organs from HCV-viremic donors to HCV-negative recipients. We also present the data collected at our institution regarding this special patient population.