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<h2>Abstarct</h2><p>The trends and outcomes of multiorgan heart-transplantation(HT) using hepatitis C virus(HCV) donors in the contemporary era are sparsely known. Using UNOS registry, 1322 adult multiorgan-HTs(n=986 heart-kidney, n=155 heart-lung, n=181 heart-liver) between August-2015 and August-2020 were identified, of which 109 were performed using HCV-donors[n=77 HCV nucleic-acid-amplification testing(NAT) positive irrespective of antibody(Ab) status(HCV-viremic); and n=32 HCV Ab+/NAT-(HCV Ab+ nonviremic)]. The percentage of HCV-donors used for multiorgan-HT increased from 0% in 2015 to 14% in 2020(p<0.001), but there was wide variation across UNOS regions and center volumes. Recipients of multiorgan heart-kidney transplants from HCV-donors(n=90) and HCV-naïve(HCV Ab-/NAT-) donors(n=896) had similar 1-year survival using unadjusted and adjusted Cox-proportional hazards-regression models including in propensity-score matched cohorts. Post-HT rates of cardiac-allograft-vasculopathy(5.4%vs.5.8%) and chronic-dialysis(7.3%vs.4.9%) at 1-year were also similar. Use of HCV-donors(HCV-viremic, HCV Ab+ nonviremic) for multiorgan-HT has increased significantly. Encouraging 1-year outcomes in heart-kidney recipients from HCV-donors should support further expansion of heart-kidney transplantation using HCV-donors.</p>

Publisher: Elsevier