Outcomes of Lung Transplantation in Recipients with Hepatitis C Virus Infection

Abstract

Hepatitis C virus (HCV) infection negatively impacts patient and graft survival following non-hepatic solid organ transplantation. Most data however are in kidney transplant, where despite modest impact on outcomes, transplantation is recommended for those with mild to moderate hepatic fibrosis given overall benefit compared to remaining on dialysis. In lung transplantation (LuTx), there is little data on outcomes and international guidelines are vague on the criteria under which transplant should be considered. The University of Alberta Lung Transplant Program routinely considers patients with HCV for lung transplant based on criteria extrapolated from the kidney transplant literature. Here we describe the outcomes of 27 HCV positive, compared to 443 HCV negative LuTx recipients. Prior to transplant, 5 patients were treated for HCV and cured. At the time of transplant, 14 patients remained HCV RNA positive. The 1, 3 and 5 year survival was similar in HCV RNA positive versus negative recipients at 93%, 77% and 77% versus 86%, 75% and 66% (p = 0.93) respectively. Long-term follow up in 8 demonstrated no significant progression of fibrosis. In our cohort HCV did not impact LuTx outcomes and in the era of interferon-free HCV therapies this should not be a barrier to LuTx.