Background: Approximately 4 million persons in the United States are chroni
cally infected with hepatitis C and morbidity due to this disease is increa
singly observed in transplant recipients. While knowledge of hepatitis C in
liver and kidney transplantation is advancing, little information is avail
able concerning hepatitis C and lung transplantation. We surveyed lung tran
splant programs about policies regarding testing for hepatitis C, transplan
tation of hepatitis C-infected candidates, and the use of organs from serop
ositive donors.
Methods: A written questionnaire was sent to all United Network of Organ Sh
aring (UNOS) approved lung transplant programs.
Results: Fifty-nine of 89 (66%) surveys were returned, including 49 from ac
tive programs, capturing 81% of lung transplants performed within UNOS prio
r to January 1998. All programs screen candidates for hepatitis C. The esti
mated median seropositivity rate among candidates was 1.9%. Thirty-three of
46 (72%) programs consider seropositive patients for transplantation and m
ost use virologic and/or histologic data to determine candidacy. All donors
are screened for hepatitis C. Twenty-six of 47 (55%) programs accept lungs
from seropositive donors and many restrict the use of organs from seroposi
tive donors to infected recipients. Few programs routinely test recipients
for hepatitis C, and policies for monitoring those with known infection are
variable.
Conclusions: Lung transplant candidates and donors are tested routinely for
hepatitis C. The majority of programs are willing to accept infected candi
dates and seropositive donors. Post-transplant follow-up of hepatitis C is
variable and prospective studies are needed to evaluate the impact of hepat
itis C on lung transplant recipients.