Rates of CAV are Not Elevated in Recipients of HCV Non-Viremic Organs

Purpose Recent data from single centers and registry analysis have demonstrated comparable one year survival after cardiac transplantation with HCV non-viremic donors. On the other hand, long-term outcomes remain unknown which is particularly relevant given the concern for accelerated CAV from HCV donors in the pre-DAART era. Therefore, in the current analysis we report our one year rates of CAV in recipients of HCV non-viremic organs. Methods A retrospective chart review was conducted of all transplants at Montefiore Medical Center between January 2017 and April 2019. Recipients were divided into 2 cohorts based on donor HCV status: non-HCV or HCV non-viremic (Ab+/NAT-). Donor and recipient characteristics as well as presence of CAV at one year assessment were collected. CAV was defined as intimal thickness >0.5mm by IVUS or OCT of the LAD when available or in cases without IVUS/OCT as Grade 1 or greater per the 2010 ISHLT CAV recommendations. Patients who received a HCV viremic organ, died before one year or did not have one year CAV assessment were excluded. Results During the study period, 97 transplants were performed. Breakdown by HCV status was: 70 non-HCV, 21 non-viremic, and 6 viremic transplants. 48 subjects in the non-HCV and 14 in HCV non-viremic categories reached one year and underwent CAV assessment. Characteristics associated with the development of CAV including recipient age, donor age, pre-transplant PRA, and rejection in the first year were not statistically different between groups. Rates of CAV were not different between recipients of non-HCV and HCV viremic organs at one year: 27% vs 14% (p=.32). At the time of presentation we anticipate data on presence of CAV on all 97 patients. Conclusion In this preliminary analysis, rates of CAV in recipients of HCV non-viremic organs were comparable to non-HCV donors. This finding provides further reassurance for the use of such donors in standard risk recipients.