Accepting Hearts From Hepatitis C-Positive Donor: Can We Expand the Donor Pool?

Autor: Grinstein J; University of Chicago Medical Center, Chicago, Illinois; Department of Medicine, Chicago, Illinois., Lourenco LM; University of Chicago Medical Center, Chicago, Illinois; Department of Medicine, Chicago, Illinois., Te HS; University of Chicago Medical Center, Chicago, Illinois; Department of Medicine, Chicago, Illinois., Renz JF; University of Chicago Medical Center, Chicago, Illinois; Department of Surgery, Chicago, Illinois., Jeevanandam V; University of Chicago Medical Center, Chicago, Illinois; Department of Surgery, Chicago, Illinois., Uriel N; University of Chicago Medical Center, Chicago, Illinois; Department of Medicine, Chicago, Illinois. Electronic address: nuriel@medicine.bsd.uchicago.edu.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2017 Oct; Vol. 23 (10), pp. 762-764. Date of Electronic Publication: 2017 Jun 13.
DOI: 10.1016/j.cardfail.2017.05.018
Abstrakt: Background: Until recently, transplantation from hepatitis C-positive donors was relatively contraindicated as eradication of active hepatitis C previously required an interferon-based regimen that has been associated with rejection in solid organ transplantation. New interferon-free treatment regimens for hepatitis C have fewer adverse events and higher cure rates than interferon-based regimens. Interferon-free regimens have been shown to be safe in the liver transplantation literature, but little is known about the safety and efficacy of treatment in heart transplantation.
Case Description and Discussion: Here we report a case of successful eradication of hepatitis C with a non-interferon-based regimen using ledipasvir-sofosbuvir following combined orthotopic heart and liver transplantation. Based on the prevalence of hepatitis C in the general population, inclusion of hepatitis C-positive donors for heart transplantation can expand this component of the donor pool 3- to 6-fold.
Conclusions: In carefully selected patients and recipients, inclusion of hepatitis C-positive donors may allow for expansion of the donor pool.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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