<h3>Introduction</h3> Highly sensitized heart transplant candidates have a longer waitlist time, worse waitlist outcomes and often require higher levels of immunosuppression post-transplantation. Expanding the heart transplant donor pool with Hepatitis C NAAT positive (Hep C NAAT (+)) donors could increase the chances of transplantation in highly sensitized patients. The effects of sensitization on post-transplant outcomes in patients who received Hep C NAAT (+) donor allografts is unknown. <h3>Methods</h3> Adult patients who received HT from a Hep C NAAT (+) donor, between May 2015 and Dec 2020, were identified from the United Network for Organ Sharing (UNOS) database. These patients were classified according to the percentage of panel reactive antibody (PRA): Non-sensitized (0%), mildly sensitized (0%-20%), Moderately sensitized (21%-50%), and highly sensitized (>50%). Clinical characteristics and post-transplant survival were compared between groups. <h3>Results</h3> A total of 831 patients received HT from a hep C NAAT (+) donor during the study period. Of these 605 (72.8%), 88 (10.6%), 70 (8.4%) and 68 (8.2%) patients were non-sensitized, mildly sensitized, moderately sensitized, and highly sensitized, respectively. Highly sensitized patients were more likely to be women and African American. The 360-day post-transplant survival was 90.8%, 92.1%, 92.7%, 93% for the non-sensitized, mildly, moderately, and highly sensitized groups, respectively (p =ns). The frequency of graft failure (p= 0.97), acute rejection (p=0.193) and coronary vasculopathy (p=0.51) were similar among groups. <h3>Conclusions</h3> Highly sensitized patients who received Hepatitis C NAAT positive allografts have similar post-transplant survival than non-sensitized patients. Thus, highly sensitized patients should not be excluded from the donor pool expansion offered by hepatitis C NAAT positive donors.