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Impact of donor and recipient hepatitis C status in lung transplantation.

Publication ,  Journal Article
Englum, BR; Ganapathi, AM; Speicher, PJ; Gulack, BC; Snyder, LD; Davis, RD; Hartwig, MG
Published in: J Heart Lung Transplant
February 2016

BACKGROUND: Studies of lung transplantation in the setting of donors or recipients with hepatitis C virus (HCV) have been limited but have raised concerns about outcomes associated with this infection. METHODS: Lung transplant cases in the United Network for Organ Sharing (UNOS) database from 1994 to 2011 were analyzed for the HCV status of both donor and recipient. First, among HCV-negative recipients, those who received a lung from an HCV-positive donor (HCV(+) D) were compared with those who received an HCV-negative lung (HCV(-) D). Donor, recipient and operative characteristics as well as outcomes were compared between groups, and overall survival was compared after adjustment for confounders. In a second analysis, HCV-positive recipients (HCV(+) R) were compared with HCV-negative recipients (HCV(-) R). The analysis was stratified by era (1994 to 1999 and 2000 to 2011) and long-term survival was compared. RESULTS: Of 16,604 HCV-negative patients in the UNOS database, 28 (0.2%) received a lung from an HCV(+) D, with use of HCV(+) D decreasing significantly over time. Overall survival (OS) was shorter in the HCV(+) D group (median survival: 1.3 vs 5.1 years; p = 0.002). Results were confirmed in adjusted analyses. After inclusion criteria were met, 289 (1.7%) of the lung transplant recipients were HCV(+) R. These patients appeared similar to their HCV(-) R counterparts, except they were older and had more limited functional status. OS was significantly lower in HCV-positive individuals during the early era (median survival: 1.7 vs 4.5 years; p = 0.004), but not the recent era (median survival: 4.4 vs 5.4 years; p = 0.100). Again, results were confirmed by adjusted analysis. CONCLUSIONS: HCV-positive status is a rare problem when considering both lung recipients and donors. Current data demonstrate significantly worse outcomes for HCV-negative patients receiving an HCV(+) lung; however, since 2000, HCV(+) recipients undergoing lung transplantation appear to have survival approximating that of HCV(-) recipients, an improvement from previous years. Recent medical advances in treatment for HCV may further improve outcomes in these groups.

Duke Scholars

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

February 2016

Volume

35

Issue

2

Start / End Page

228 / 235

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tissue Donors
  • Surgery
  • Middle Aged
  • Male
  • Lung Transplantation
  • Humans
  • Hepatitis C
  • Female
  • Adult
 

Citation

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Englum, B. R., Ganapathi, A. M., Speicher, P. J., Gulack, B. C., Snyder, L. D., Davis, R. D., & Hartwig, M. G. (2016). Impact of donor and recipient hepatitis C status in lung transplantation. J Heart Lung Transplant, 35(2), 228–235. https://doi.org/10.1016/j.healun.2015.10.012
Englum, Brian R., Asvin M. Ganapathi, Paul J. Speicher, Brian C. Gulack, Laurie D. Snyder, R Duane Davis, and Matthew G. Hartwig. “Impact of donor and recipient hepatitis C status in lung transplantation.J Heart Lung Transplant 35, no. 2 (February 2016): 228–35. https://doi.org/10.1016/j.healun.2015.10.012.
Englum BR, Ganapathi AM, Speicher PJ, Gulack BC, Snyder LD, Davis RD, et al. Impact of donor and recipient hepatitis C status in lung transplantation. J Heart Lung Transplant. 2016 Feb;35(2):228–35.
Englum, Brian R., et al. “Impact of donor and recipient hepatitis C status in lung transplantation.J Heart Lung Transplant, vol. 35, no. 2, Feb. 2016, pp. 228–35. Pubmed, doi:10.1016/j.healun.2015.10.012.
Englum BR, Ganapathi AM, Speicher PJ, Gulack BC, Snyder LD, Davis RD, Hartwig MG. Impact of donor and recipient hepatitis C status in lung transplantation. J Heart Lung Transplant. 2016 Feb;35(2):228–235.
Journal cover image

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

February 2016

Volume

35

Issue

2

Start / End Page

228 / 235

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tissue Donors
  • Surgery
  • Middle Aged
  • Male
  • Lung Transplantation
  • Humans
  • Hepatitis C
  • Female
  • Adult