Study on Transplanting Hepatitis C Positive Organs
Background of Organ Transplantation Challenges
A recent study explored the safety and effectiveness of transplanting organs from hepatitis C positive (HCV-positive) donors into hepatitis C negative (HCV-negative) transplant recipients who undergo antiviral therapy. Each year, numerous patients awaiting heart transplants either succumb to their condition or become too ill for surgery. Those who do receive a heart often face extended waiting times due to a shortage of available donors. This issue has been compounded by the ongoing opioid crisis, which has resulted in an increase in potential organ donors contracting HCV, leading to the discarding of their organs.
Advancements in Direct-Acting Antiviral Therapies
Historically, treatments for HCV were linked to poor outcomes and significant side effects. However, recent advancements in direct-acting antiviral (DAA) therapies have shown remarkable effectiveness in curing HCV with minimal adverse effects. Researchers propose that transplanting HCV-infected organs into HCV-negative recipients, followed by DAA treatment, could enable the use of these organs without compromising recipient health.
Previous Research Findings
Five independent studies have reported a 100% cure rate for HCV-positive organ transplantation following DAA treatment. Nonetheless, only one of these studies involved heart transplants, underscoring the need for further rigorous investigations to assess the safety of transplanting HCV-positive hearts into HCV-negative patients.
Details of the Recent Study
To address this gap, McLean and colleagues conducted a study involving 10 HCV-negative patients in need of heart transplants. Each participant received a heart from an HCV-positive donor and subsequently underwent a twelve-week DAA therapy regimen, which included elbasvir and grazoprevir. The researchers monitored HCV levels and any adverse events throughout the study, with findings published in the American Journal of Transplantation.
Study Results
All 10 participants exhibited detectable levels of HCV three days post-transplantation. By the end of the treatment course, nine out of the ten participants did not experience any adverse effects and were successfully cured of HCV. Unfortunately, one patient passed away on day 79 due to antibody-mediated rejection; however, this was not attributed to the HCV-positive organ transplantation or the DAA therapy.
Conclusions and Future Implications
The researchers concluded that HCV-negative patients who received HCV-positive organs were cured of the virus without encountering adverse events, thanks to DAA treatment. Ongoing studies aim to explore the feasibility of applying a similar approach to other HCV-positive organs, such as lungs and kidneys. Additionally, larger and longer-term trials are needed to further assess the safety and effectiveness of HCV-positive organ transplants following antiviral therapy.
Reference
McLean, R. C., Reese, P. P., Acker, M., Atluri, P., Bermudez, C., Goldberg, L., … & Bloom, R. D. (2019). Transplanting hepatitis C virus‐infected hearts into uninfected recipients: A single‐arm trial. American Journal of Transplantation.
Written by
Haisam Shah, BSc