In a pilot research study being conducted at the University of Pennsylvania, early results suggest that kidneys from hepatitis C-positive donors may be appropriate for transplantation now that HCV is a curable condition.
Imagine that you or a loved one needs an organ transplant in order to live another month, or week or day and there was a perfectly viable heart or kidney available but it had to be discarded because the would-be organ donor was infected with hepatitis C – it would be devastating. Currently, that is the reality that organ transplant hopefuls face.
Until recently, HCV was only treatable, perhaps curable, for less than half the people who received treatment for it, but with the advent of oral medications that offer a cure for the vast majority of people who take it. It is this change that has allowed researchers to consider the possibility of transplanting the organs of HCV-positive donors, then treating the HCV in the organ recipient if s/he develops hepatitis C after the transplant.
In the first leg of the pilot program, researchers enrolled 10 people who were receiving chronic kidney dialysis or peritoneal dialysis, had no living donors available, were negative for hepatitis C and met a number of other criteria. A number of exclusion criteria were also used, including the transplant hopefuls having chronic liver disease or liver cancer, HIV positive or on a waiting list for multiple organ transplants.
All ten of the transplant recipients received one kidney from a donor who was HCV positive and all ten developed HCV by the third day following surgery, an outcome each enrollee was made aware of previous to the transplant through a three-step informed consent process. Each transplant patient was then initiated on a 12-week course of Zepatier (elbasvir–grazoprevir) after which all ten of the transplant patients were cured of HCV. Just as important, the kidney transplants in all 10 people were deemed successful.
This clinical trial for the use of HCV-positive organs for transplant is testing not only the viability of using these now-discarded organs for transplant but also the medication Zepatier, a product of Merck Sharp and Dohme for the treatment of HCV in those transplant recipients. A second leg of the pilot program is intended to replicate the research for heart transplants.
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