Cardiac allograft vasculopathy in heart transplant recipients from hepatitis C viremic donors
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Wiley
2024
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| author | Bernard S. Kadosh Antoinette S. Birs Erin Flattery Maxine Stachel Kimberly N. Hong Yuhe Xia Claudia Gidea Saima Aslam Louai Razzouk Tajinderpal Saraon Randal Goldberg Shaline Rao Victor Pretorius Nader Moazami Deane E. Smith Eric D. Adler Alex Reyentovich |
| author_facet | Bernard S. Kadosh Antoinette S. Birs Erin Flattery Maxine Stachel Kimberly N. Hong Yuhe Xia Claudia Gidea Saima Aslam Louai Razzouk Tajinderpal Saraon Randal Goldberg Shaline Rao Victor Pretorius Nader Moazami Deane E. Smith Eric D. Adler Alex Reyentovich Bernard S. Kadosh Antoinette S. Birs Erin Flattery Maxine Stachel Kimberly N. Hong Yuhe Xia Claudia Gidea Saima Aslam Louai Razzouk Tajinderpal Saraon Randal Goldberg Shaline Rao Victor Pretorius Nader Moazami Deane E. Smith Eric D. Adler Alex Reyentovich |
| collection | Wiley Open Access |
| contents | Cardiac allograft vasculopathy in heart transplant recipients from hepatitis C viremic donors Bernard S. Kadosh Antoinette S. Birs Erin Flattery Maxine Stachel Kimberly N. Hong Yuhe Xia Claudia Gidea Saima Aslam Louai Razzouk Tajinderpal Saraon Randal Goldberg Shaline Rao Victor Pretorius Nader Moazami Deane E. Smith Eric D. Adler Alex Reyentovich Clinical Transplantation AbstractBackgroundRecent studies suggest the transplantation of Hepatitis C (HCV) hearts from viremic donors is associated with comparable 1 year survival to nonviremic donors. Though HCV viremia is a known risk factor for accelerated atherosclerosis, data on cardiac allograft vasculopathy (CAV) outcomes are limited. We compared the incidence of CAV in heart transplant recipients from HCV viremic donors (nucleic acid amplification test positive; NAT+) compared to non‐HCV infected donors (NAT−).MethodsWe retrospectively reviewed annual coronary angiograms with intravascular ultrasound from April 2017 to August 2020 at two large cardiac transplant centers. CAV was graded according to ISHLT guidelines. Maximal intimal thickness (MIT) ≥ 0.5 mm was considered significant for subclinical disease.ResultsAmong 270 heart transplant recipients (mean age 54; 77% male), 62 patients were transplanted from NAT+ donors. CAV ≥ grade 1 was present in 8.8% of the NAT+ versus 16.8% of the NAT‐ group at 1 year, 20% versus 28.8% at 2 years, and 33.3% versus 41.5% at 3 years. After adjusting for donor age, donor smoking history, recipient BMI, recipient, hypertension, and recipient diabetes, NAT+ status did not confer increased risk of CAV (HR.80; 95% CI.45–1.40, p = 0.43) or subclinical IVUS disease (HR.87; 95% CI.58–1.30, p = 0.49). Additionally, there was no difference in the presence of rapidly progressive lesions on IVUS.ConclusionOur data show that NAT+ donors conferred no increased risk for early CAV or subclinical IVUS disease following transplantation in a cohort of heart transplant patients who were treated for HCV, suggesting the short‐term safety of this strategy to maximize the pool of available donor hearts. 10.1111/ctr.15294 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.15294 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_15294 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Cardiac allograft vasculopathy in heart transplant recipients from hepatitis C viremic donors Bernard S. Kadosh Antoinette S. Birs Erin Flattery Maxine Stachel Kimberly N. Hong Yuhe Xia Claudia Gidea Saima Aslam Louai Razzouk Tajinderpal Saraon Randal Goldberg Shaline Rao Victor Pretorius Nader Moazami Deane E. Smith Eric D. Adler Alex Reyentovich Clinical Transplantation Cardiac allograft vasculopathy in heart transplant recipients from hepatitis C viremic donors Bernard S. Kadosh Antoinette S. Birs Erin Flattery Maxine Stachel Kimberly N. Hong Yuhe Xia Claudia Gidea Saima Aslam Louai Razzouk Tajinderpal Saraon Randal Goldberg Shaline Rao Victor Pretorius Nader Moazami Deane E. Smith Eric D. Adler Alex Reyentovich Clinical Transplantation AbstractBackgroundRecent studies suggest the transplantation of Hepatitis C (HCV) hearts from viremic donors is associated with comparable 1 year survival to nonviremic donors. Though HCV viremia is a known risk factor for accelerated atherosclerosis, data on cardiac allograft vasculopathy (CAV) outcomes are limited. We compared the incidence of CAV in heart transplant recipients from HCV viremic donors (nucleic acid amplification test positive; NAT+) compared to non‐HCV infected donors (NAT−).MethodsWe retrospectively reviewed annual coronary angiograms with intravascular ultrasound from April 2017 to August 2020 at two large cardiac transplant centers. CAV was graded according to ISHLT guidelines. Maximal intimal thickness (MIT) ≥ 0.5 mm was considered significant for subclinical disease.ResultsAmong 270 heart transplant recipients (mean age 54; 77% male), 62 patients were transplanted from NAT+ donors. CAV ≥ grade 1 was present in 8.8% of the NAT+ versus 16.8% of the NAT‐ group at 1 year, 20% versus 28.8% at 2 years, and 33.3% versus 41.5% at 3 years. After adjusting for donor age, donor smoking history, recipient BMI, recipient, hypertension, and recipient diabetes, NAT+ status did not confer increased risk of CAV (HR.80; 95% CI.45–1.40, p = 0.43) or subclinical IVUS disease (HR.87; 95% CI.58–1.30, p = 0.49). Additionally, there was no difference in the presence of rapidly progressive lesions on IVUS.ConclusionOur data show that NAT+ donors conferred no increased risk for early CAV or subclinical IVUS disease following transplantation in a cohort of heart transplant patients who were treated for HCV, suggesting the short‐term safety of this strategy to maximize the pool of available donor hearts. 10.1111/ctr.15294 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Cardiac allograft vasculopathy in heart transplant recipients from hepatitis C viremic donors |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.15294 |