McLean RC, et al. - Researchers conducted a single-arm trial of orthotopic heart transplantation (OHT) from hepatitis C virus (HCV)-infected donors into uninfected recipients, followed by elbasvir/grazoprevir treatment after recipient HCV was first detected. From May 16, 2017 to May 10, 2018, they screened 20 patients who consented for enrollment; OHT was performed on 10 patients (median age 52.5 years; 80% male). Sustained virologic response at 12 weeks (SVR-12) was achieved in 9 recipients. Antibody-mediated rejection and multi-organ failure, and subsequently death on day 79 was reported in the 10th recipient who had a positive cross-match. HCV transmission or treatment led to no serious adverse events. These findings suggest acceptable outcomes in HCV-negative candidates transplanted with HCV-infected hearts.