Hearts and lungs donated from people who were hepatitis C-positive can be safely transplanted into non-infected patients, according to a study published Wednesday in the New England Journal of Medicine.
Researchers look to expand organ donor pool
The study is part of a growing body of research that seeks to test whether the organ donor pool could be expanded to include organs from patients who were hepatitis C-positive. According to the latest data from the United Network for Organ Sharing, more than 100,000 people are on the waitlist to receive a lifesaving organ transplant. Last year, researchers at Johns Hopkins University and the University of Pennsylvania showed doctors could safely transplant hepatitis C-positive kidneys into non-infected patients by treating and ultimately curing the recipients of Hepatitis C infection.
But in the latest study, researchers at Brigham and Women's Hospital took a different approach. The researchers tested whether doctors could safely transplant more fragile organs, like hearts and lungs, from hepatitis C-positive donors, and whether they could prevent recipients from developing hepatitis C at all. Hepatitis C drugs can cost hundreds of thousands of dollars per course, so shortening the treatment period could generate huge cost savings.
The study included 44 patients—36 of whom received a lung transplant and eight of whom who received a heart transplant from hepatitis C-positive patients. The researchers also tested a new treatment method. Instead of waiting for the virus to infect the donor and begin treatment, the Brigham researchers began a month-long course of hepatitis C treatment to try to prevent the virus from infecting the recipients.
Among the first 35 patients enrolled in the study, the researchers found none of the patients had detectable levels of hepatitis C about two weeks after transplantation. At six-month follow ups, the virus remained undetectable and each recipient's organs were functioning properly. The researchers said patients did not experience any serious adverse events from the early month-long treatment method, which they noted was shorter and less costly than the typical hepatitis C treatment.
Ann Woolley, an infectious disease specialist who organized the study, said, "We've had a 100% success rate, both in terms of the hepatitis C clearance as well as how well the patient has done after transplant."
In an accompanying editorial, Emily Blumberg of the University of Pennsylvania wrote, "The early results are very encouraging, but there is still a lot to learn." She noted the she would like to see studies with longer follow-up periods, as there is a concern the transplant recipients could have a higher risk of heart disease later in life (Harris, "Shots," NPR, 4/3; AP/New York Times, 4/3).
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