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In Reply: We agree with Drs Taylor and Fontana that the safety and efficacy of transplanting organs from donors seropositive for HCV might vary with different organ type. Although our study suggests that the use of HCV-positive donors conveys an early and sustained survival disadvantage among heart transplant recipients, other studies suggest similar patient survival among liver transplant recipients¹ and differences in survival only after 3 to 5 years posttransplant among kidney transplant recipients.² In contrast, little is known about the consequences of transplanting lung, pancreas, and intestinal allografts from HCV-positive donors.

While receipt of a heart from an HCV-positive donor results in inferior outcomes among heart transplant recipients, it might, nonetheless, be a practical option for candidates otherwise facing imminent death. Furthermore, outcomes associated with the use of HCV-positive donors should be assessed as better therapies for HCV are identified and the interactions between host immunity and the natural . . . [Full Text of this Article]

Leanne B. Gasink, MD, MSCE
leanne.gasink@uphs.upenn.edu

Emily A. Blumberg, MD; A. Russell Localio, PhD; Ebbing Lautenbach, MD, MPH, MSCE
University of Pennsylvania
Philadelphia

Shashank S. Desai, MD
Inova Fairfax Hospital
Falls Church, Va

Ajay K. Israni, MD, MS
University of Minnesota
Minneapolis

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Hepatitis C Virus Seropositivity in Organ Donors and Survival in Heart Transplant Recipients
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