Hepatitis C-Infected Kidneys Viable for Life-Saving Transplants

Organ transplant recipients who received infected kidneys were cured of hepatitis C after taking antiviral therapy following the procedure.

The benefits of transplanting kidneys from donors with hepatitis C virus (HCV) may outweigh the risks for individuals in need of a lifesaving organ transplant, according to a new study.

Although organs that test positive for HCV are often discarded due to the risk of infecting recipients, transplanting HCV-infected kidneys can be safe for patients when followed by treatment with direct-acting antiviral drugs, according to preliminary data from 2 small trials.

In the study, published in Annals of Internal Medicine, researchers from Penn Medicine examined the safety of transplanting kidneys infected with HCV in 20 patients. The data included 12-month HCV treatment outcomes in 10 patients and 6-month outcomes in another 10 patients.

According to the findings, all 20 patients who received infected kidneys were cured of their contracted HCV and reported good quality of life following their transplant. Additionally, the researchers reported kidney function comparable with patients who received uninfected organs, even a year after the procedure. This suggests that HCV infection did not harm the quality of the transplant, they noted.

“This study, and the results, are good news for those in need of a transplant, particularly those patients who were facing tremendous wait times—often 5, 7, even 10 years—and who were spending so much of their daily lives on dialysis,” lead author Peter Reese, MD, MSCE, associate professor of Medicine and Epidemiology, said in a press release.

The results echo an earlier report published in Hepatology suggesting that HCV-positive liver transplantation outweighed the potential risk of waiting for an uninfected liver for patients. When followed with antiviral therapy, cure rates in these patients exceeded 90% after the procedure, according to the study.

For patients who may not survive the wait for a healthy organ, opting in for an HCV-infected organ could be a viable option, the researchers noted.

“While larger, longer term studies are important to confirm these results, we can confidently say that hospitals nation-wide could perform hundreds or thousands more transplants if we increased our acceptance of organs from donors with hepatitis C,” Dr Reese concluded.

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References

Reese PP, Abt PL, Blumberg EA, et al. Twelve-month outcomes after transplant of hepatitis C—infected kidneys into uninfected recipients: a single-group trial. Annals of Internal Medicine. 2018. Doi: 10.7326/M18-0749

Advancing Transplantation: Hepatitis C-infected Organs Safe for Transplantation When Followed by Antiviral Treatment [news release]. Penn Medicine’s website. https://www.pennmedicine.org/news/news-releases/2018/august/advancing-transplantation-hepatitis-c-infected-organs-safe-for-transplantation. Accessed August 7, 2018.