| (Philadelphia, PA) – Researchers at the University
of Pennsylvania’s School of Medicine have found that
heart transplant patients who receive a donor heart from a person
with hepatitis C (HCV) have a lower rate of survival. Corresponding
Author Leanne Gasink, MD, MSCE, of the University
of Pennsylvania’s Division of Infectious Disease and colleagues
report their findings in the October 17th issue of The Journal
of the American Medical Association.
Each year between 10% and 20 % of patients awaiting heart transplants
expire due to the critical shortage of available cardiac organs.
One potential solution formed by the American Heart Association
in 2001 to narrow this gap stated HCV-positive donors “may
be appropriate in selected higher-risk recipients.” Despite
the substantial risk of HCV transmission to the patient and subsequent
liver enzyme damage, the effects on patient survival have previously
“Some medical experts have advocated the use of HCV-positive
cardiac organs because of shortages in suitable donor hearts,”
Gasink said. "This approach should be used cautiously as use
of HCV-positive donors is associated with decreased survival, even
in older recipients."
Dr. Gasink’s study used data from the Scientific Registry
of Transplant Recipients. All adult heart transplant recipients
from April 1994 to July 2003 were eligible for inclusion. Out of
10,915 patients documented, 261 received an HCV-positive heart.
Using Kaplan-Meier methods, the study found the survival rates
lower among HCV-positive recipients compared with HCV-negative recipients
at 1 year (83% vs. 92%), 5 years (53% vs. 77%), and 10 years (25%
vs. 53%). The rate of death was also higher among recipients of
HCV-positive hearts compared to HCV-negative hearts. At 1, 5, and
10 years, death rates for HCV-positive organs were 16.9 %, 41.8%,
and 50.6% versus 8.2%, 18.5%, and 24.3 % for HCV-negative cardiac
organs. These numbers appear to be independent of recipient age
and HCV status. Furthermore, recipients of HCV-positive donor hearts
were more likely to die from liver disease and coronary artery disease.
Study co-authors include Emily Blumberg and Ebbing Lautenbach from
the Division of Infectious Disease at Penn; A. Russell Localio from
the Department of Biostatics and Epidemiology at Penn; Shashank
Desai from the Heart Failure and Transplant Program at Inova Fairfax
Hospital; and Ajay Israni from the Hennepin County Medical Center.
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