Hepatitis C liver transplant first, then cure hep C

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New antiviral drugs that can actually cure hepatitis C are proving so effective that doctors are now doing what had previously been unheard of: They are transplanting infected livers into patients who are on liver transplant wait lists, and then curing the hepatitis C afterward, something that used to be impossible.

Pet sitter 39-year-old Kimberly Wilt had a fatty liver, which developed into cirrhosis. She found herself on the liver transplant list.

"I was in shock," she said. "I'm in my 30s; how am I going to have a transplant at this time? I wasn't prepared for it whatsoever."

Multiple calls fell through, and then her doctor asked if she would be willing to take a hepatitis C-infected liver.

"We told her, we said, 'Look, it's very easy now, you take a pill daily between eight to 12 weeks, and we guarantee between 97% to 99% cure rate," Dr. Robert Rahimi said.

"When he took my liver out, he said it looked like I was walking a tightrope: One day it would have just completely failed, and who knows if there would have been a liver that would have matched my blood type, my size, and been in good enough condition for a transplant?" Wilt said.

Taking the antiviral drugs, Wilt's hepatitis C was undetectable within three months.

"I have a new life," she said. "It's completely new, it's not anywhere near where it was a year ago."

"This is now adapting all across the United States and the world. Over time, it's going to save thousands of lives," Rahimi said.

There are nearly 17,000 people in the United States waiting for a liver transplant. A new study published in the New England Journal of Medicine reports these new antiviral drugs are so effective that other infected body parts, such as hearts and lungs, can also be transplanted, then cleared of the hepatitis C after the transplant.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: HEP C LIVER TRANSPLANT FIRST, THEN CURE HEP C
REPORT: MB #4638

BACKGROUND: In order to undergo a liver transplant, a patient must be placed on the national waiting list. The list is managed by the United Network for Organ Sharing (UNOS), which collects and manages all data that pertain to the patient waiting list, organ donation and matching, and transplantation occurring on the OPTN, the nation's organ transplant network. All liver transplant candidates in the United States must be listed with UNOS before a donor liver can be allocated. Currently there are nearly 17,000 people waiting for a liver transplant in the United States. The median national waiting time in 2006 was 321 days. (Source: https://columbiasurgery.org/liver/liver-transplant-waiting-list)

HEP C: Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. It is also a major cause of liver cancer. A new infection with HCV does not always require treatment, as the immune response in some people will clear the infection. However, when HCV infection becomes chronic, treatment is necessary. The goal of hepatitis C treatment is cure. Robert Rahimi, MD, a Transplant Hepatologist at Baylor Scott and White in Dallas says the cure rate for hep C is greater than 97 percent. (Source: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c & Robert Rahimi, MD)

NEW TREATMENT: Dr. Rahimi explained what used to happen to these infected organs, "Infected organs in the past could only be used in patients that had hepatitis C because you're taking out their liver or heart or lung or kidneys. They already had hepatitis C and it goes through the bloodstream. And let's say an organ came available that had hepatitis C. We could only give it to those patients that were already infected. Now with the advent of antiviral therapies, we are curing many, many patients. It's almost like it's limiting Hepatitis C from the baby boomers those that are asymptomatic. They don't know that they have hepatitis C. So the new organs that become available because of the opioid epidemic that are found to have hepatitis C, in the past we would actually discard them. But nowadays with informed consent we say look we can use these. Patients that are on the wait list - they can die on the wait list. Their mortality is a few percentages per month dying or at least waiting for an organ. Instead of that, we can actually give the organ to a patient and cure them afterwards." (Source: Robert Rahimi, MD)