Effect of Hepatitis C Positivity on Survival in Adult Patients Undergoing Heart Transplantation (from the United Network for Organ Sharing Database)

Concerns exist regarding orthotropic heart transplantation in hepatitis C virus (HCV) seropositive recipients. Thus, a national registry was accessed to evaluate early and late outcome in HCV seropositive recipients undergoing heart transplant. Retrospective analysis of the United Network for Organ...

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Published in:The American journal of cardiology 2016-07, Vol.118 (1), p.132-137
Main Authors: Kumar, Sachin, MD, Deo, Salil V., MD, Altarabsheh, Salah E., MD, Dunlay, Shannon M., MD, MS, Sarabu, Nagaraju, MD, MPH, Sareyyupoglu, Basar, MD, Elgudin, Yakov, MD, Medalion, Benjamin, MD, ElAmm, Chantal, MD, Ginwalla, Mahazarin, MD, Zacharias, Michael, MD, Benatti, Rodolpho, MD, Oliveira, Guilherme H., MD, Kilic, Ahmet, MD, Fonarow, Gregg C., MD, Park, Soon J., MD
Format: Article
Language:English
Subjects:
Adult
Age
Alcohol
Antigens
Blood groups
Cardiomyopathy
Cardiovascular
Cocaine
Cytomegalovirus
Diabetes
Female
Graft Survival
Heart failure
Heart Failure - mortality
Heart Failure - surgery
Heart Failure - virology
Heart Transplantation
Hepatitis
Hepatitis B virus
Hepatitis C - complications
Hepatitis C virus
Humans
Male
Middle Aged
Mortality
Patients
Postoperative period
Registries
Retrospective Studies
Survival Rate
Transplants & implants
Treatment Outcome
United States
Variables
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cited_by cdi_FETCH-LOGICAL-c547t-b78914856c67bead270eb107c77798515d4e70476cbe86361fe7928d118256d43
cites cdi_FETCH-LOGICAL-c547t-b78914856c67bead270eb107c77798515d4e70476cbe86361fe7928d118256d43
container_end_page 137
container_issue 1
container_start_page 132
container_title The American journal of cardiology
container_volume 118
creator Kumar, Sachin, MD
Deo, Salil V., MD
Altarabsheh, Salah E., MD
Dunlay, Shannon M., MD, MS
Sarabu, Nagaraju, MD, MPH
Sareyyupoglu, Basar, MD
Elgudin, Yakov, MD
Medalion, Benjamin, MD
ElAmm, Chantal, MD
Ginwalla, Mahazarin, MD
Zacharias, Michael, MD
Benatti, Rodolpho, MD
Oliveira, Guilherme H., MD
Kilic, Ahmet, MD
Fonarow, Gregg C., MD
Park, Soon J., MD
description Concerns exist regarding orthotropic heart transplantation in hepatitis C virus (HCV) seropositive recipients. Thus, a national registry was accessed to evaluate early and late outcome in HCV seropositive recipients undergoing heart transplant. Retrospective analysis of the United Network for Organ Sharing registry (1991 to 2014) was performed to evaluate recipient profile and clinical outcome of patients with HCV seropositive (HCV +ve) and seronegative (HCV −ve). Adjusted results of early mortality and late survival were compared between cohorts. From 23,507 patients (mean age 52 years; 75% men), 481 (2%) were HCV +ve (mean age 52 years; 77% men). Annual proportion of HCV +ve recipients was comparable over the study period (range 1.3% to 2.7%; p = 0.2). The HCV +ve cohort had more African-American (22% vs 17%; p = 0.01), previous left ventricular assist device utilization (21% vs 14%; p
doi_str_mv 10.1016/j.amjcard.2016.04.023
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Thus, a national registry was accessed to evaluate early and late outcome in HCV seropositive recipients undergoing heart transplant. Retrospective analysis of the United Network for Organ Sharing registry (1991 to 2014) was performed to evaluate recipient profile and clinical outcome of patients with HCV seropositive (HCV +ve) and seronegative (HCV −ve). Adjusted results of early mortality and late survival were compared between cohorts. From 23,507 patients (mean age 52 years; 75% men), 481 (2%) were HCV +ve (mean age 52 years; 77% men). Annual proportion of HCV +ve recipients was comparable over the study period (range 1.3% to 2.7%; p = 0.2). The HCV +ve cohort had more African-American (22% vs 17%; p = 0.01), previous left ventricular assist device utilization (21% vs 14%; p &lt;0.01) and more hepatitis B core Ag+ve recipients (17% vs 5%; p &lt;0.01). However, both cohorts were comparable in terms of extracorporeal membrane oxygenator usage (p = 0.7), inotropic support (p = 0.2), intraaortic balloon pump (p = 0.7) support, serum creatinine (p = 0.7), and serum bilirubin (p = 0.7). Proportion of status 1A patients was similar (24% HCV + vs 21% HCV −); however, wait time for HCV +ve recipients were longer (mean 23 vs 19 days; p &lt;0.01). Among donor variables, age (p = 0.8), hepatitis B status (p = 0.4), and Center for Diseases Control high-risk status (p = 0.9) were comparable in both cohorts. At a median follow-up of 4 years, 67% patients were alive, 28% died, and 1.1% were retransplanted (3.4% missing). Overall survival was worse in the HCV+ cohort (64.3% vs 72.9% and 43.2% vs 55% at 5 and 10 years; p &lt;0.01), respectively. Late renal (odds ratio [OR] 1.2 [1 to 1.6]; p = 0.02) and liver dysfunction (odds ratio 4.5 [1.2 to 15.7]; p = 0.01) occurs more frequently in HCV +ve recipients. On adjusted analysis, HCV seropositivity is associated with poorer survival (hazard ratio for mortality 1.4 [1.1 to 1.6]; p &lt;0.001). In conclusion, a small proportion of patients receiving a heart transplant in the United States have hepatitis C. Despite comparable preoperative hepatic function, hepatitis C seropositive recipients demonstrate poorer long-term survival.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2016.04.023</identifier><identifier>PMID: 27189814</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age ; Alcohol ; Antigens ; Blood groups ; Cardiomyopathy ; Cardiovascular ; Cocaine ; Cytomegalovirus ; Diabetes ; Female ; Graft Survival ; Heart failure ; Heart Failure - mortality ; Heart Failure - surgery ; Heart Failure - virology ; Heart Transplantation ; Hepatitis ; Hepatitis B virus ; Hepatitis C - complications ; Hepatitis C virus ; Humans ; Male ; Middle Aged ; Mortality ; Patients ; Postoperative period ; Registries ; Retrospective Studies ; Survival Rate ; Transplants &amp; implants ; Treatment Outcome ; United States ; Variables</subject><ispartof>The American journal of cardiology, 2016-07, Vol.118 (1), p.132-137</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 1, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-b78914856c67bead270eb107c77798515d4e70476cbe86361fe7928d118256d43</citedby><cites>FETCH-LOGICAL-c547t-b78914856c67bead270eb107c77798515d4e70476cbe86361fe7928d118256d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27189814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Sachin, MD</creatorcontrib><creatorcontrib>Deo, Salil V., MD</creatorcontrib><creatorcontrib>Altarabsheh, Salah E., MD</creatorcontrib><creatorcontrib>Dunlay, Shannon M., MD, MS</creatorcontrib><creatorcontrib>Sarabu, Nagaraju, MD, MPH</creatorcontrib><creatorcontrib>Sareyyupoglu, Basar, MD</creatorcontrib><creatorcontrib>Elgudin, Yakov, MD</creatorcontrib><creatorcontrib>Medalion, Benjamin, MD</creatorcontrib><creatorcontrib>ElAmm, Chantal, MD</creatorcontrib><creatorcontrib>Ginwalla, Mahazarin, MD</creatorcontrib><creatorcontrib>Zacharias, Michael, MD</creatorcontrib><creatorcontrib>Benatti, Rodolpho, MD</creatorcontrib><creatorcontrib>Oliveira, Guilherme H., MD</creatorcontrib><creatorcontrib>Kilic, Ahmet, MD</creatorcontrib><creatorcontrib>Fonarow, Gregg C., MD</creatorcontrib><creatorcontrib>Park, Soon J., MD</creatorcontrib><title>Effect of Hepatitis C Positivity on Survival in Adult Patients Undergoing Heart Transplantation (from the United Network for Organ Sharing Database)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Concerns exist regarding orthotropic heart transplantation in hepatitis C virus (HCV) seropositive recipients. Thus, a national registry was accessed to evaluate early and late outcome in HCV seropositive recipients undergoing heart transplant. Retrospective analysis of the United Network for Organ Sharing registry (1991 to 2014) was performed to evaluate recipient profile and clinical outcome of patients with HCV seropositive (HCV +ve) and seronegative (HCV −ve). Adjusted results of early mortality and late survival were compared between cohorts. From 23,507 patients (mean age 52 years; 75% men), 481 (2%) were HCV +ve (mean age 52 years; 77% men). Annual proportion of HCV +ve recipients was comparable over the study period (range 1.3% to 2.7%; p = 0.2). The HCV +ve cohort had more African-American (22% vs 17%; p = 0.01), previous left ventricular assist device utilization (21% vs 14%; p &lt;0.01) and more hepatitis B core Ag+ve recipients (17% vs 5%; p &lt;0.01). However, both cohorts were comparable in terms of extracorporeal membrane oxygenator usage (p = 0.7), inotropic support (p = 0.2), intraaortic balloon pump (p = 0.7) support, serum creatinine (p = 0.7), and serum bilirubin (p = 0.7). Proportion of status 1A patients was similar (24% HCV + vs 21% HCV −); however, wait time for HCV +ve recipients were longer (mean 23 vs 19 days; p &lt;0.01). Among donor variables, age (p = 0.8), hepatitis B status (p = 0.4), and Center for Diseases Control high-risk status (p = 0.9) were comparable in both cohorts. At a median follow-up of 4 years, 67% patients were alive, 28% died, and 1.1% were retransplanted (3.4% missing). Overall survival was worse in the HCV+ cohort (64.3% vs 72.9% and 43.2% vs 55% at 5 and 10 years; p &lt;0.01), respectively. Late renal (odds ratio [OR] 1.2 [1 to 1.6]; p = 0.02) and liver dysfunction (odds ratio 4.5 [1.2 to 15.7]; p = 0.01) occurs more frequently in HCV +ve recipients. On adjusted analysis, HCV seropositivity is associated with poorer survival (hazard ratio for mortality 1.4 [1.1 to 1.6]; p &lt;0.001). In conclusion, a small proportion of patients receiving a heart transplant in the United States have hepatitis C. Despite comparable preoperative hepatic function, hepatitis C seropositive recipients demonstrate poorer long-term survival.</description><subject>Adult</subject><subject>Age</subject><subject>Alcohol</subject><subject>Antigens</subject><subject>Blood groups</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular</subject><subject>Cocaine</subject><subject>Cytomegalovirus</subject><subject>Diabetes</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Heart failure</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - surgery</subject><subject>Heart Failure - virology</subject><subject>Heart Transplantation</subject><subject>Hepatitis</subject><subject>Hepatitis B virus</subject><subject>Hepatitis C - complications</subject><subject>Hepatitis C virus</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patients</subject><subject>Postoperative period</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Transplants &amp; 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Deo, Salil V., MD ; Altarabsheh, Salah E., MD ; Dunlay, Shannon M., MD, MS ; Sarabu, Nagaraju, MD, MPH ; Sareyyupoglu, Basar, MD ; Elgudin, Yakov, MD ; Medalion, Benjamin, MD ; ElAmm, Chantal, MD ; Ginwalla, Mahazarin, MD ; Zacharias, Michael, MD ; Benatti, Rodolpho, MD ; Oliveira, Guilherme H., MD ; Kilic, Ahmet, MD ; Fonarow, Gregg C., MD ; Park, Soon J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-b78914856c67bead270eb107c77798515d4e70476cbe86361fe7928d118256d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Age</topic><topic>Alcohol</topic><topic>Antigens</topic><topic>Blood groups</topic><topic>Cardiomyopathy</topic><topic>Cardiovascular</topic><topic>Cocaine</topic><topic>Cytomegalovirus</topic><topic>Diabetes</topic><topic>Female</topic><topic>Graft Survival</topic><topic>Heart failure</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - surgery</topic><topic>Heart Failure - virology</topic><topic>Heart Transplantation</topic><topic>Hepatitis</topic><topic>Hepatitis B virus</topic><topic>Hepatitis C - complications</topic><topic>Hepatitis C virus</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patients</topic><topic>Postoperative period</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Transplants &amp; 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Thus, a national registry was accessed to evaluate early and late outcome in HCV seropositive recipients undergoing heart transplant. Retrospective analysis of the United Network for Organ Sharing registry (1991 to 2014) was performed to evaluate recipient profile and clinical outcome of patients with HCV seropositive (HCV +ve) and seronegative (HCV −ve). Adjusted results of early mortality and late survival were compared between cohorts. From 23,507 patients (mean age 52 years; 75% men), 481 (2%) were HCV +ve (mean age 52 years; 77% men). Annual proportion of HCV +ve recipients was comparable over the study period (range 1.3% to 2.7%; p = 0.2). The HCV +ve cohort had more African-American (22% vs 17%; p = 0.01), previous left ventricular assist device utilization (21% vs 14%; p &lt;0.01) and more hepatitis B core Ag+ve recipients (17% vs 5%; p &lt;0.01). However, both cohorts were comparable in terms of extracorporeal membrane oxygenator usage (p = 0.7), inotropic support (p = 0.2), intraaortic balloon pump (p = 0.7) support, serum creatinine (p = 0.7), and serum bilirubin (p = 0.7). Proportion of status 1A patients was similar (24% HCV + vs 21% HCV −); however, wait time for HCV +ve recipients were longer (mean 23 vs 19 days; p &lt;0.01). Among donor variables, age (p = 0.8), hepatitis B status (p = 0.4), and Center for Diseases Control high-risk status (p = 0.9) were comparable in both cohorts. At a median follow-up of 4 years, 67% patients were alive, 28% died, and 1.1% were retransplanted (3.4% missing). Overall survival was worse in the HCV+ cohort (64.3% vs 72.9% and 43.2% vs 55% at 5 and 10 years; p &lt;0.01), respectively. Late renal (odds ratio [OR] 1.2 [1 to 1.6]; p = 0.02) and liver dysfunction (odds ratio 4.5 [1.2 to 15.7]; p = 0.01) occurs more frequently in HCV +ve recipients. On adjusted analysis, HCV seropositivity is associated with poorer survival (hazard ratio for mortality 1.4 [1.1 to 1.6]; p &lt;0.001). In conclusion, a small proportion of patients receiving a heart transplant in the United States have hepatitis C. Despite comparable preoperative hepatic function, hepatitis C seropositive recipients demonstrate poorer long-term survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27189814</pmid><doi>10.1016/j.amjcard.2016.04.023</doi><tpages>6</tpages></addata></record>
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identifier ISSN: 0002-9149
ispartof The American journal of cardiology, 2016-07, Vol.118 (1), p.132-137
issn 0002-9149
1879-1913
language eng
recordid cdi_proquest_miscellaneous_1808715483
source ScienceDirect Freedom Collection 2022-2024
subjects Adult
Age
Alcohol
Antigens
Blood groups
Cardiomyopathy
Cardiovascular
Cocaine
Cytomegalovirus
Diabetes
Female
Graft Survival
Heart failure
Heart Failure - mortality
Heart Failure - surgery
Heart Failure - virology
Heart Transplantation
Hepatitis
Hepatitis B virus
Hepatitis C - complications
Hepatitis C virus
Humans
Male
Middle Aged
Mortality
Patients
Postoperative period
Registries
Retrospective Studies
Survival Rate
Transplants & implants
Treatment Outcome
United States
Variables
title Effect of Hepatitis C Positivity on Survival in Adult Patients Undergoing Heart Transplantation (from the United Network for Organ Sharing Database)
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