Review of heart transplantation from hepatitis C-positive donors.

Palak Patel, Nirav Patel, Fahad Ahmed, Jason Gluck
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Abstract

Significant scarcity of a donor pool exists for heart transplantation (HT) as the prevalence of patients with end-stage refractory heart failure is increasing exceptionally. With the discovery of effective direct-acting antiviral and favorable short-term outcomes following HT, the hearts from hepatitis C virus (HCV) patient are being utilized to increase the donor pool. Short-term outcomes with regards to graft function, coronary artery vasculopathy, and kidney and liver disease is comparable in HCV-negative recipients undergoing HT from HCV-positive donors compared to HCV-negative donors. A significant high incidence of donor-derived HCV transmission was observed with great success of achieving sustained viral response with the use of direct-acting antivirals. By accepting HCV-positive organs, the donor pool has expanded with younger donors, a shorter waitlist time, and a reduction in waitlist mortality. However, the long-term outcomes and impact of specific HCV genotypes remains to be seen. We reviewed the current literature on HT from HCV-positive donors.

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回顾丙型肝炎阳性捐献者的心脏移植手术。
由于终末期难治性心力衰竭患者的发病率异常增加,心脏移植(HT)的供体库非常稀缺。随着有效的直接作用抗病毒药物的发现以及心脏移植术后良好的短期疗效,人们开始利用丙型肝炎病毒(HCV)患者的心脏来增加供体库。在移植功能、冠状动脉血管病变、肝肾疾病等方面,与 HCV 阴性供体相比,接受 HCV 阳性供体心脏移植的 HCV 阴性受者的短期疗效相当。在使用直接作用抗病毒药物成功实现持续病毒应答的同时,也观察到供体源性 HCV 传播的高发生率。通过接受 HCV 阳性器官,捐献者库扩大了,捐献者更加年轻,等待时间缩短,等待者死亡率降低。然而,特定 HCV 基因型的长期结果和影响仍有待观察。我们回顾了目前有关来自 HCV 阳性捐献者的 HT 的文献。
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