Impact of donor and recipient hepatitis C status in lung transplantation
Section snippets
UNOS database
UNOS has maintained the Standard Transplant Analysis and Research files of waitlisted transplant candidates, recipients and donors in the USA since 1987.13 UNOS assures data quality through trained data abstracters and managers, quality checks and on-site auditing, and these prospective data are used to provide risk-adjusted performance measures.14
Study population
Using the UNOS database, all lung transplant cases from 1987 through 2011 were identified, with cases of pediatric and multiple-organ transplantation
Results
Of 16,604 transplant recipients without HCV, 28 recipients (0.2%) were transplanted with lungs from an HCV+ D. This use decreased significantly over time, from 0.73% during 1994 to 1996 to 0.06% from 2000 to 2011 (p < 0.001 for temporal trend in annual rate). HCV+ D had higher rates of tobacco abuse (64.3% vs 20.0%; p < 0.001) and trended toward older age (median: 36 vs 30 years; p = 0.072), but were otherwise similar. Recipients from the HCV+ D group were more likely to be on life support, in
Discussion
Lung transplant specialists are in the difficult position of weighing the needs of a challenging patient population and availability of a valuable but limited resource. The use of lung transplantation in HCV infection is rare, and this study we have described the trends in utilization, the patient population involved, and outcomes that can be expected. Use of HCV+ D in lung transplantation has decreased significantly, with only 3 cases recorded since 2005, whereas cases in HCV+ R have remained
Disclosure statement
The authors have no conflicts of interest to disclose. B.R.E. is partially supported by the National Institutes of Health (Grant U01 HL088942).
This study was presented at the 34th annual meeting and scientific sessions of the International Society for Heart and Lung Transplantation, April 2014, San Diego, California.
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2022, PulmonologyCitation Excerpt :CMV-specific IgG test shows high sensitivity and specificity; in the case of negativity, a second test should be performed immediately before transplant; uncertain results should be considered positive and the patient at high risk.71 The incidental diagnosis of a chronic viral infection (e.g., HIV, HCV, HBV) can lead to a reassessment of LT feasibility and timing.72–76 Serology related to vaccine-preventable diseases (e.g., HAV and HBV, MMR, and VZV) is mandatory to plan an immunization program before LT, mainly for live attenuated vaccines (e.g., MMR and VZV vaccines).77