Utilization of hepatitis C virus–infected organ donors in cardiothoracic transplantation
Patient Guideline Summary
Publication Date: May 1, 2020
This patient summary means to discuss key recommendations from the International Society for Heart and Lung Transplantation for the utilization of hepatitis C virus−infected organ donors in cardiothoracic transplantation. It is limited to adults 18 years of age and older and should not be used as a reference for children.
- Transplantation has become a successful treatment for organ failure. Transplanting hearts, lungs, livers and kidneys is now standard practice.
- One major hazard is when the donated organ carries an infection. This is especially dangerous because preventing organ rejection in the recipient also impairs the immune response to infections.
- Within the past ten years, six cures for hepatitis C have become available, raising the hope of more organs available for donation, since there are never enough.
- Extensive trials have now resulted in approved protocols for transplanting organs from hepatitis C-infected donors.
- We will use the abbreviation HCV throughout this summary to refer to the hepatitis C virus.
- This patient summary focuses on managing recipients of HCV-infected organs.
(Most donors are dead, never knew they were infected, and were never treated.)
- All potential organ donors are screened for every possible infection as well as all other conditions that would affect the organ recipient.
- If you are being considered for an organ transplant, you are always incurable by any other treatment and considered “terminal” without an organ replacement.
- You will also be thoroughly screened. Many patients are not suitable for the rigors and risks of such a major intervention.
- There are two protocols for managing you as an HCV-infected organ recipient:
- Immediate treatment
- Treating after confirming an HCV infection.
- At this time, neither has proved superior.
- Each of the six treatments has a slightly different dosing duration and indications for usage. All are tablets taken by mouth once daily.
- Intensive testing for active infection will be part of the overall management of your organ transplant.
- Throughout your experience with this major process, your treatment team will confer with you and your loved ones, assuring you understand the procedures, the risks, and the possible outcomes.
- Infected organ transplantation is only recently become feasible and is therefore subject to rapidly evolving improvements based on accumulating experience.
Aslam S, Grossi P, Schlendorf KH, Holm AM, Woolley AE, Blumberg E, Mehra MR; working group members. Utilization of hepatitis C virus-infected organ donors in cardiothoracic transplantation: An ISHLT expert consensus statement. J Heart Lung Transplant. 2020 May;39(5):418-432. doi: 10.1016/j.healun.2020.03.004. Epub 2020 Mar 19. PMID: 32362393.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.