August 13, 2018

'Hundreds or thousands' more kidney transplants may be possible after promising new study

Daily Briefing

    About two years ago, Johns Hopkins University and University of Pennsylvania researchers sought to broaden the pool of kidney donors by testing whether hepatitis C-positive organs could be safely transplanted into non-infected patients—and their results suggest such transplants can be successful.

    Here are 5 key tactics to attract and retain transplant patients

    Background

    Nearly 95,000 people are on the national kidney waiting list, but only 19,850 people received a kidney transplant last year, according to the United Network for Organ Sharing (UNOS). And each year, about 4% of people on the waiting list die while waiting for a kidney.

    But researchers from Johns Hopkins University and the University of Pennsylvania in 2016 launched a trial to determine whether they could safely transplant hepatitis C-positive organs into non-infected patients—and whether that would broaden the prospective donor pool.

    If left untreated, hepatitis C can destroy a person's liver, but breakthrough hepatitis C drugs with 95% cure rates and relatively mild side effects have made the disease significantly more manageable.

    Peter Reese, a kidney specialist at the University of Pennsylvania who co-led the study, said, "When there's such a bad organ shortage, we can't just do business as usual. We need to shake off that these organs aren't valuable and that people will not want them."

    Success two years later

    Last week, the researchers published a study in the Annals of Internal Medicine that found after 12 months a group of patients without hepatitis C who received kidney transplants from donors with the virus were cured of hepatitis C and are experiencing good quality of life.  

    The study detailed full data from the trial, including 12-month hepatitis C outcomes for 10 patients and sixth-month outcomes for 10 others. The researchers found the 20 patients were cured of the hepatitis C virus and their kidney function is similar to patients who received kidneys from donors without the virus. According to a release from Penn Medicine, the comparable kidney function suggest that the hepatitis C infection did not compromise the quality of the transplant.

    Further, the patients in the study have reported good quality of life since the transplants.

    Discussion

    Reese said the results of the study are "good news for those in need of a transplant, particularly those patients who were facing tremendous wait time—often five, seven, even 10 years—and who were spending so much of their daily lives on dialysis."

    Reese added that while more studies are important to confirm the study's results, "we can confidently say that hospitals nationwide could perform hundreds or thousands more transplants if we increased our acceptance of organs from donors with hepatitis C."

    David Goldberg, an assistant professor of medicine and epidemiology at Penn Medicine who co-led the study said his team hopes the success of these kidney transplants could extend to other organs like hearts. "We hope to see this same kind of success with our heart transplant recipients, many of whom are already showing no signs of [hepatitis C] in their blood after transplantation and treatment," he said.

    The American Society of Transplantation said larger studies need to be done before the transplantation of infected kidneys can be done regularly (Knowles, Becker's Clinical Leadership & Infection Control, 8/8; CBS News, 8/7; Penn Medicine news release, 8/6).

    Here are 5 key tactics to attract and retain transplant patients

    Download this briefing to learn how to expand the pipeline of potential transplant patients and engage them across the care pathway.

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