Our Summary

This research paper explores the use of hearts from hepatitis C-positive donors for heart transplants. The study finds that these donors can help increase the number of available hearts for transplant, reduce waiting times, and decrease the number of deaths among those waiting for a transplant.

The study involved 80 adult patients, who received heart transplants from hepatitis C-positive donors. The majority of these patients developed hepatitis C from the donor’s heart. However, they were successfully treated with antiviral drugs, and the infection did not affect their survival after one year.

The researchers concluded that, with the use of these antiviral drugs, hearts from hepatitis C-positive donors can be safely used for transplants. This could potentially reduce waiting times and save lives, without significant risk to the patient’s survival.

FAQs

  1. Can hearts from hepatitis C-positive donors be used for heart transplants?
  2. What are the implications of using hearts from hepatitis C-positive donors for heart transplants?
  3. How can the infection from hepatitis C-positive donors be managed in transplant patients?

Doctor’s Tip

One helpful tip a doctor might give to a patient about heart transplant is to discuss the option of receiving a heart from a hepatitis C-positive donor with their healthcare team. While initially concerning, the use of hearts from these donors can actually be a viable option with the proper treatment. It’s important for patients to be informed about all potential options in order to increase the chances of receiving a transplant and improving their quality of life.

Suitable For

Patients who are typically recommended for a heart transplant are those with end-stage heart failure that is not responding to other treatments, such as medication or surgery. These patients may have severe symptoms such as shortness of breath, fatigue, chest pain, and fluid retention, and their condition may be life-threatening.

Other criteria for heart transplant candidacy include:

  • Severe damage to the heart muscle, such as from a heart attack or cardiomyopathy
  • Inability to perform daily activities due to heart failure
  • Short life expectancy without a transplant
  • Absence of other medical conditions that would make a transplant risky or unlikely to be successful

Patients undergoing a heart transplant evaluation will undergo a series of tests to assess their overall health, heart function, and suitability for surgery. They will also be evaluated for their ability to adhere to a rigorous post-transplant medication regimen and lifestyle changes.

In cases where there is a shortage of donor hearts available, as seen in the study on hepatitis C-positive donors, patients may be considered for heart transplants from donors with certain risk factors, such as a history of hepatitis C. These patients would need to be carefully monitored and treated for any potential complications, but may still benefit from a transplant if other options are limited.

Timeline

Before Heart Transplant:

  1. Patient is diagnosed with severe heart failure that is not responding to other treatments.
  2. Patient undergoes extensive testing to determine if they are a suitable candidate for a heart transplant.
  3. Patient is added to the national transplant waiting list and waits for a suitable donor heart to become available.

After Heart Transplant:

  1. Patient receives a call that a donor heart has become available and goes to the hospital for the transplant surgery.
  2. The surgery is performed, typically lasting several hours.
  3. Patient is closely monitored in the intensive care unit for the first few days after surgery.
  4. Patient begins a long recovery process, which includes physical therapy, medication management, and regular follow-up appointments.
  5. Patient may experience complications such as rejection of the new heart, infection, or side effects from the anti-rejection medications.
  6. Patient gradually resumes normal activities and experiences improved quality of life with their new heart.

What to Ask Your Doctor

  1. What are the risks associated with receiving a heart transplant from a hepatitis C-positive donor?
  2. How will the hepatitis C infection be monitored and treated post-transplant?
  3. What is the success rate of treating hepatitis C in heart transplant recipients with antiviral drugs?
  4. How will the use of a heart from a hepatitis C-positive donor affect my long-term prognosis and survival rate?
  5. How will this type of transplant impact my overall quality of life and recovery process?
  6. Are there any specific precautions or additional care measures I need to take post-transplant due to the hepatitis C infection?
  7. What are the alternative options available to me if I choose not to receive a heart from a hepatitis C-positive donor?
  8. How will the use of hearts from hepatitis C-positive donors affect the overall wait time and availability of organs for transplant recipients?
  9. Are there any ongoing research or clinical trials related to using organs from hepatitis C-positive donors for transplantation?
  10. How will the medical team monitor and manage any potential complications or side effects related to the hepatitis C infection post-transplant?

Reference

Authors: Schlendorf KH, Zalawadiya S, Shah AS, Perri R, Wigger M, Brinkley DM, Danter MR, Menachem JN, Punnoose LR, Balsara K, Sacks SB, Ooi H, Awad JA, Sandhaus E, Schwartz C, O’Dell H, Carver AB, Edmonds CL, Ruzevich-Scholl S, Lindenfeld J. Journal: JAMA Cardiol. 2020 Feb 1;5(2):167-174. doi: 10.1001/jamacardio.2019.4748. PMID: 31851352