Advances in treating hep C allows non-affected patients to accept organs from donors with the virus. Previously, such organs typically were discarded or used only for recipients who already had hep C.

News, Your Health | 2 years ago

Hepatitis C No Longer an Obstacle for Transplant Recipients

Advances in treating hep C allows non-affected patients to accept organs from donors with the virus. Previously, such organs typically were discarded or used only for recipients who already had hep C.

Sharon Price had come to grips with the notion that dialysis would soon be part of his life.

Facing a long wait for a new kidney, he was 73 years old and his condition had grown progressively over two years. He was ready to begin the treatment, but first had a request for his doctors at Atrium Health’s Carolinas Medical Center.

“I was going to do it [dialysis], no ifs and or buts,” Sharon says. “But I wanted to put it off for two months because it was summer, and I wanted to do spend time with my grandchildren.”

Granted an extension, he enjoyed the vacation with his family. Two weeks before he was scheduled to begin initial steps in in preparation for dialysis, Sharon received a call from Vincent Casingal, MD, chief of the division of abdominal transplant surgery and the surgical director of the kidney transplant program at Atrium Health.

Dr. Casingal offered Sharon the opportunity to become Atrium Health’s first non-hepatitis C patient to receive a hepatitis C kidney.

New hope for an old problem

Until recently, organs donated by individuals with hepatitis C were typically either discarded or used only for patients with hepatitis C. A blood-borne virus that historically led to severe liver damage, hepatitis C cases had declined steadily throughout the years before increasing sharply in the mid-2000s, largely due to needles associated with drug use.

Organ donors with the infection greatly outnumber patients who need transplants but who don’t have the infection. As a result, scores of organs have gone unused as transplant patients linger on wait lists. But thanks to advances in treating hepatitis C, doctors are discovering that it is safe to use donated organs from affected individuals. Andrew deLemos, MD, was among the first in the region to identify this opportunity and helped to spearhead the development of the protocol to utilize organs from hepatitis C positive donors and the follow-up care for the recipients of these organs. 

Dr. Casingal says Sharon was a perfect candidate to receive a 24-year-old kidney from a donor who had been exposed to hepatitis C.

“To not have to go through dialysis,” Sharon says, “I was more than happy to take a hep C kidney!”

“He most likely would not have received one otherwise because the wait list is so long for his blood type,” Dr. Casingal says. “He didn’t have a living donor coming forward for him. He didn’t have pre-existing liver disease. And he was healthy enough to take the medication afterward if he did catch hep C.”

The prospect excited Sharon, who says he didn’t have any reservations. He knew enough about to dialysis to know he wanted to avoid it.

“This has given me hope I can see my grandkids go to college and do things I want to do. It’s been a wonderful deal,” says Sharon.

Prospects for the future

Two of Atrium Health's experts in hepatology, Mark Russo, MD, and Philippe Zamor, MD, have been at the forefront of trials for hepatitis C medications released in the last several years. The new medications have a cure rate between 95-98%, giving the teams at Atrium Health the confidence to move forward with innovative transplants like Sharon was able to receive.

“Other places are doing these transplants under research protocol, but this is non-experimental for us,” Dr. Casingal says. “This is entering our standard of care and we’re starting to offer it to more people.”

More people includes Sharon, who received his new kidney on June 28, 2019. Following Sharon’s surgery, six other Atrium Health patients have received hepatitis C organs, including four kidneys and three livers. Increasing the number of similar transplants will help address the organ shortage, which is a national crisis.

According to the U.S. Department of Health and Human Services, more than 113,000 individuals were on the national transplant waiting list as of July 2019, and 20 people die each day waiting for a transplant. Patients near the top of the list might decline the opportunity to receive a hepatitis C organ, but Dr. Casingal wants those at Atrium Health to have that option.

“We have a shared goal of taking care of these patients and feel privileged to do so,” he says. “It’s one of the things we really enjoy in transplant, which is a changing field. One year ago, we would’ve thrown away Sharon’s new kidney. Now we’re using it and it’s working.”

Nearly six months after his surgery, Sharon says he has no signs of hepatitis C, no complications, and no regrets. But he does have a piece of advice for anybody with kidney disease:

“If a kidney with hep C becomes available,” he says, “get it and enjoy a wonderful gift for the rest of your life.”