Heart and lungs from hepatitis C viremia (HCV)-infected donors are not transplanted, but the rise of direct-acting antiviral agents for HCV has raised the possibility of safe transplants. The objective of this study is to evaluate the effect of heart and lung transplants from HCV-infected donors to uninfected recipients.

This is a clinical trial that involved a total of 44 patients: 36 received lung transplants, and 8 received heart transplants from HCV-infected donors. The recipients were then assigned to sofosbuvir–velpatasvir treatment for the four weeks following immediately after transplantation. The primary outcome of the study was a composite of sustained virologic response at the follow-up of 12 weeks. 

A total of 42 out of 44 patients (95%) had a detectable hepatitis C viral load immediately after transplantation. Initially, 35 patients were followed-up at six months, and all 35 patients (100%) were alive with undetectable HCV infection and good graft function. Similar results were reported in other patients as well. No serious treatment-related adverse events were identified during the trial.

The research concluded that patients who had received lung and heart transplants from HCV-infected donors, followed by antiviral regimen for four weeks had undetectable HCV and food graft function.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1812406