Some patients facing a years-long wait for a kidney transplant are jumping ahead in line thanks to a startling experiment: They're agreeing to an organ almost sure to infect them with hepatitis C.
Hopefully treatable infection
Knowingly transmitting a dangerous virus may
Some patients facing a years-long wait for a kidney transplant are jumping ahead in line thanks to a startling experiment: They're agreeing to an organ almost sure to infect them with hepatitis C.
Hopefully treatable infection
Knowingly transmitting a dangerous virus may sound drastic, but two leading transplant centres are betting the strategy will save lives, if new medications that promise to cure hepatitis C allow use of organs that today go to waste.
Pilot studies are underway at the University of Pennsylvania and Johns Hopkins University to test transplanting kidneys from deceased donors with hepatitis C into recipients who don't already have that virus. If the research eventually pans out, hundreds more kidneys – and maybe some hearts and lungs, too – could be transplanted every year.
Read: Is a kidney transplant a good option?
"We always dreaded hepatitis C," said Dr Peter Reese, a Penn kidney specialist who is helping lead the research. "But now hepatitis C is just a different disease," enough to consider what he calls the trade-off of getting a new kidney years faster but one that comes with a hopefully treatable infection.
It's a trade-off prompted by the nation's organ shortage. More than 99,000 people are on the national kidney waiting list, but only about 17,000 people a year get a transplant and four percent a year die waiting, according to the United Network for Organ Sharing (UNOS).
"If we had enough organs, we wouldn't do this," said Dr Niraj Desai, who is leading the Hopkins study. But, Desai said, "Most patients are pretty open to the idea once they hear what the alternatives are."
Doctors had told 66-year-old Irma Hendricks of East Stroudsburg, Pennsylvania, to expect at least a five-year wait for a kidney transplant. Dialysis three times a week was keeping her alive, but leaving her with no energy for even routine activities. "I call it the zombie syndrome," she said.
She jumped at the chance to enrol in Penn's study, even though doctors made clear they hoped for but couldn't guarantee a hepatitis cure.
"My son said, 'Mom, this is a no-brainer. Just do it,'" Hendricks said.
She swallowed an anti-hepatitis pill daily for three months, in addition to the usual post-transplant medications. Testing showed the drugs rapidly cleared hepatitis C out of her bloodstream. With her new kidney functioning well, she now has enough energy to play with her toddler grandson.
Read: Hepatitis C
"This is giving people in my situation new hope," Hendricks said.
Kidney transplant specialists are closely watching the research.
"It makes sense to me," said Dr Matthew Cooper, a transplant surgeon at MedStar Georgetown University Hospital who is not involved in the research. He cautioned that the studies should use only kidneys that are young and otherwise high-quality, and that patients must understand the risks.
A simmering infection
"They need to know you place their safety as the highest priority," Cooper said. "But at the same time, rec