Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Clin Transplant. 2021 Apr;35(4):e14220. doi: 10.1111/ctr.14220. Epub 2021 Jan 18.
Recent studies demonstrated safety and efficacy of heart transplantation (HT) from hepatitis C virus (HCV)-positive donors. We sought to evaluate the impact of HCV donor status on the outcomes of patients undergoing HT in the United States.
We analyzed a retrospective cohort of adult patients from the United Network for Organ Sharing (UNOS) database who underwent isolated HT from 2015 until present. Primary outcomes were 30-day and 1-year overall mortality. Secondary outcomes included risk for graft failure and overall survival, incident stroke and need for dialysis during the available follow-up period. All end points were evaluated according to HCV status.
All-cause 30-day and 1-year mortality was similar between the two groups (3.4% vs 3.2%, P = .973 and 6.9% vs 7.8%, P = .769, respectively, for patients receiving heart grafts from HCV+ vs. HCV- donors). Graft failure was 12.8% (95% CI: 8%-19%) and 15.2% (95 CI: 15%-16%) in the HCV+ and HCV- groups, respectively (P = .92 and P = .68). Competing risk regression analysis for re-operation showed a non-significant trend for higher risk for re-transplantation in the HCV+ group (HR: 2.71; 95% CI: 0.83, 8.80, P = .097).
HCV donor status does not seem to negatively affect the outcomes of HT in the U.S population.
最近的研究表明，来自丙型肝炎病毒（HCV）阳性供体的心脏移植（HT）是安全且有效的。我们旨在评估 HCV 供体状态对美国接受 HT 患者结局的影响。
我们分析了美国器官共享联合网络（UNOS）数据库中从 2015 年至今接受单纯 HT 的成年患者的回顾性队列。主要结局是 30 天和 1 年总死亡率。次要结局包括移植物失败和总生存率、卒中发生率和在可获得的随访期间需要透析的发生率。所有终点均根据 HCV 状态进行评估。
两组患者的全因 30 天和 1 年死亡率相似（分别为 3.4%比 3.2%，P = 0.973 和 6.9%比 7.8%，P = 0.769，分别为接受 HCV+供体和 HCV-供体心脏移植物的患者）。HCV+组和 HCV-组的移植物失败率分别为 12.8%（95%CI：8%-19%）和 15.2%（95%CI：15%-16%）（P = 0.92 和 P = 0.68）。HCV+组再次移植的风险较高，但竞争风险回归分析显示这一趋势无统计学意义（HR：2.71；95%CI：0.83，8.80，P = 0.097）。
HCV 供体状态似乎不会对美国人群 HT 的结局产生负面影响。
