Center and Individual Willingness to Consider Heart and Lung Offers From Donors With Hepatitis C

J Surg Res. 2024 Oct:302:175-185. doi: 10.1016/j.jss.2024.07.043. Epub 2024 Aug 3.

Abstract

Introduction: Transplants with hearts and lungs from donors with hepatitis C virus (HCV D+) have been proven safe and effective since development of direct-acting antivirals, yet the presence of HCV + persists as a reason to decline organs.

Methods: We identified adult candidates listed January 1, 2015-March 8, 2023 for heart or lung transplant using the Scientific Registry of Transplant Recipients. We identified individual-level and center-level characteristics associated with listing to consider HCV D+ offers using multilevel logistic regression in a multivariable framework.

Results: Over the study period, the annual percentage of candidates willing to consider HCV D+ offers increased for both heart (9.5%-74.3%) and lung (7.8%-59.5%), as did the percentage of centers listing candidates for HCV D+ heart (52.9%-91.1%) and lung (32.8%-82.8%) offers. Candidates at centers with more experience with HCV D+ transplants were more likely to consider HCV D+ organ offers. After adjustment, listing center explained 70% and 78% of the residual variance in willingness to consider HCV D+ hearts and lungs, respectively.

Conclusions: Although listing for consideration of HCV D+ offers has increased, it varies by transplant center. Center-level barriers to consideration of HCV D+ organs reduce recipients' transplant access.

Keywords: Heart transplant; Hepatitis C; Lung transplant; Outcomes; Waitlist.

MeSH terms

  • Adult
  • Aged
  • Female
  • Heart Transplantation* / psychology
  • Heart Transplantation* / statistics & numerical data
  • Hepatitis C* / epidemiology
  • Humans
  • Lung Transplantation* / statistics & numerical data
  • Male
  • Middle Aged
  • Registries / statistics & numerical data
  • Tissue Donors* / psychology
  • Tissue Donors* / statistics & numerical data
  • Tissue and Organ Procurement* / statistics & numerical data
  • United States / epidemiology