Hepatitis C (HCV) has become readily treatable in the modern era. The use of HCV+ organs for transplant has shown promising results and increases donor availability. This study is an updated analysis of outcomes after HCV+ heart transplantation in the United States. The United Network for Organ Sharing registry was queried for adult patients who received heart transplants from 2015-2018. Excluded multiorgan transplants, incomplete HCV data, and loss to follow-up. HCV status was classified by serology (Ab+ vs Ab-). Median follow-up was 24 months. During the study period, 7529 patients received heart transplants: 136 from HCV Ab+ donors and 7393 from HCV Ab- donors. Seven recipients (5.1%) of HCV Ab+ hearts had HCV+ serology prior to transplant, compared to 129 recipients (1.7%) of HCV Ab- organs (p=0.018). There was no difference in donor age (p=0.489), ejection fraction (p=0.221), gender mismatch (p=0.341), or ABO compatibility (p=0.707). HCV Ab+ transplants involved further travel (mean: 323 vs 149 miles, p<0.001) with longer ischemic times (mean: 3.55 vs 3.03 hours, p<0.001) due to regional variation in use of HCV+ organs. Kaplan Meier analysis showed no effect of HCV status on overall survival (p=0.960), and no difference in graft failure (p=0.700). On multivariate Cox regression, HCV status was not a significant predictor of mortality (HR 0.85, 95% CI 0.47-1.56, p=0.601), while overall mortality was affected by HLA mismatch (HR 1.07, 95% CI 1.00-1.14, p= 0.037), donor age (HR 1.01, 95% CI 1.00-1.02, p=0.002), recipient creatinine (HR 1.07, 95% CI 1.04-1.12, p<0.001), and use of ECMO (HR 3.27, 95% CI 2.08-5.12, p<0.001) or a ventricular assist device (HR 1.23, 95% 1.08-1.41, p=0.003) at the time of transplant. Transplantation of HCV+ donor hearts has demonstrated promising outcomes thus far, with comparable overall survival and graft outcomes. Ongoing investigation is warranted to observe long-term outcomes.