title: Outcomes after lung transplantation and practices of lung transplant programs in the United States regarding hepatitis C seropositive recipients.
abstract: BACKGROUND
  The estimated prevalence of hepatitis C virus (HCV) infection among lung transplant (LT) recipients is 1.9%. Many thoracic transplant programs are reluctant to transplant HCV-seropositive patients due to concerns of hepatic dysfunction caused by immunosuppression. The aims of this study are to survey current practices of US LT programs regarding HCV-seropositive patients and using the Organ Procurement and Transplantation Network/United Network for Organ Sharing database and to assess the clinical outcomes of HCV-positive compared with HCV-negative LT recipients.
  
  
  METHODS
  A survey of US transplant centers that have performed more than 100 LTs was conducted. In addition, 170 HCV-seropositive and 9259 HCV-seronegative recipients who received HCV-seronegative donor organs between January 1, 2000, to December 31, 2007, were identified from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database. Outcome variables including patient survival were compared between the two groups.
  
  
  RESULTS
  A total of 64.4% centers responded to the survey. Ten of 29 (34.5%) programs would not consider HCV-seropositive patients for LT. Among the 19 programs that will consider HCV-seropositive patients, only five centers would transplant actively viremic patients. Overall patient survival rates of HCV-seropositive patients were similar to HCV-seronegative patients (84.7% at 1 year, 63.9% at 3 years, 49.4% at 5 years for HCV-seropositive group vs. 82.0% at 1 year, 65.0% at 3 years, 51.4% at 5 years for HCV-seronegative group, P=0.712). Relative risk of recipients for death remained statistically insignificant after adjusting for recipient age, donor age, obesity, sensitization, serum creatinine, and medical condition at time of transplant (relative risk [RR]=1.07 [0.84-1.38], P=0.581).
  
  
  CONCLUSIONS
  Since 2000, patient survival rates of HCV-positive patients are identical to those who are HCV-negative. However, most of these HCV-seropositive patients were probably nonviremic.
authors.affiliation: Abdominal Transplantation Program, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, USA. tselingf@usc.edu
authors.forename: Tse-Ling
authors.initials: TL
authors.lastname: Fong
authors.forename: Yong W
authors.initials: YW
authors.lastname: Cho
authors.forename: Linda
authors.initials: L
authors.lastname: Hou
authors.forename: Ian V
authors.initials: IV
authors.lastname: Hutchinson
authors.forename: Richard G
authors.initials: RG
authors.lastname: Barbers
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Herrington
mesh_terms: D000328:Adult; D000368:Aged; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D016040:Lung Transplantation / Q000401:mortality*; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral