Expanding the Pool in Orthotopic Heart Transplantation

Inclusion criteria (recipients): * End stage heart failure * Age ≥ 18 and \<71 years * Listed heart transplant at UPMC * Have panel reactive antibody level of \<98% * No obvious contraindication to liver transplant * Able to travel to UPMC for routine post-transplant visits and study visits for a minimum of 12 months after transplantation * Able to provide informed consent * Be willing to use a contraceptive method for a year after transplant Inclusion criteria (donors): * HCV antibody positive * HCV NAT negative or positive * Acceptable cardiac function for donation Exclusion criteria (recipients): * HIV positive * HCVAb or HCV RNA positive * Presence of behavioral risk factors for contracting HCV. These behavioral risk factors are current injection drug use, current intranasal illicit drug use, current percutaneous/parenteral exposures in an unregulated setting. * Hepatitis B surface antigen positive * History of liver cirrhosis * Persistently elevated liver transaminases, defined as ALT/AST at least 3 times the upper limit of normal for a minimum of 3 consecutive months * Waitlisted for a multi-organ transplant * Pregnant women * Known allergy to sofosbuvir/velpatasvir * Any condition, psychiatric or physical, that in the opinion of the investigator would make it unsafe to proceed with transplantation or interfere with the ability of the subject to participate in the study * Ongoing therapy with amiodarone for atrial or ventricular arrhythmia Prescribed use of Amiodarone Exclusion criteria (donors): * Confirmed HIV positive (positive HIV-1 antibody, positive HIV-2 antibody, positive p24 antigen and/or positive HIV NAT) * Confirmed HBV positive (positive hepatitis B surface antigen and/or HBV NAT) Known ongoing therapy for HCV