Advancing transplantation: Hepatitis C-infected organs safe for transplantation when followed by antiviral treatment

Twenty patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease, according to a study published today in Annals of Internal Medicine. The researchers also report that the kidney transplants for these 20 patients are functioning just as well as kidneys that are transplanted from similar donors without HCV.

In 2016, Penn Medicine launched an innovative clinical trial to test the effect of transplanting kidneys from donors with HCV into patients currently on the kidney transplant waitlist who do not have the virus, and who would opt in to receive these otherwise unused organs. Recipients were then treated with an antiviral therapy in an effort to cure the virus after transplantation.

A research team co-led by Peter Reese, MD, MSCE, an associate professor of Medicine and Epidemiology, and David S. Goldberg, MD, MSCE, an assistant professor of Medicine and Epidemiology, report full data from the trial which includes 12-month HCV treatment outcomes in 10 patients and six month outcomes in another 10 patients — all of whom have received a lifesaving kidney transplant, who have been cured of their contracted HCV, and who have reported good quality of life following their transplants. More, the finding that these 20 kidney transplant recipients have kidney function that is similar to recipients of kidney transplants from donors without HCV suggests that the HCV infection did not harm the quality of the transplant.

“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 five, seven, even 10 years — and who were spending so much of their daily lives on dialysis,” said Reese. “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.”

In addition to studying the safety and efficacy of this method in kidney transplantation, the team replicated this same approach for those awaiting a heart transplant in a study which launched in 2017. “We hope to see this same kind of success with our heart transplant recipients, many of whom are already showing no signs of HCV in their blood after transplantation and treatment,” said Goldberg.

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