Hepatitis C transplants save hearts

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Right now, as many as 4,000 people in the United States are waiting for a heart or heart and lung transplant, and more than 25% will die before they get a donor organ.

Some of the top transplantation programs in the country are now addressing the shortage by accepting hearts from donors who had active hepatitis C.

Recipients know they'll get the disease, but so far, they've all been cured.

Kerry Hayes has had a faulty aortic valve since he was born.

"I wasn't getting the oxygen I was supposed to get," Hayes said. "Blood would flow back and forth instead of all one direction."

He got an artificial heart a year and a half ago, which is almost as long as he was on the list for a donor heart.

His doctor found Hayes a heart from a donor who had hep C. It could be cured with antiretrovirals after surgery.

Hayes got his heart and just found out his hep C is gone.

"I felt that I was probably going to be cured, but you know, it feels good to have somebody tell you, yes, you are for surely cured," he said.

Transplant surgeon Dr. Jorge Reyes says 20 livers and hearts from donors with circulating hepatitis C have gone to patients so far.

"They're hep C-negative. They have never been exposed to hep C, but the risk of dying of their liver disease or their heart disease, et cetera, is very high," Reyes said.

Twelve patients have been cured of hep C, seven are still getting treatment and one died of transplant complications. No potential recipient has said no.

"If we have a donor who is hepatitis C-positive and with healthy organs, all those organs should be used," Reyes said.

Hayes is still taking a lot of anti-rejection medication, but he's delighted to get back to his normal life.

"All the signs are pointing to getting back to being like everyone else," he said.

Reyes says his team is looking at expanding the program to include kidneys from hep C-infected donors, but he wants more study done first.

In an initial study, 20 patients at Penn Medicine in Philadelphia were cured of hep C after kidney transplants from infected donors.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: HEP C TRANSPLANTS SAVE HEARTS
REPORT: MB #4679

BACKGROUND: More than 145 million people have registered as organ donors, but only about 3 in every 1,000 can become donors when they die. While most organ and tissue donation occur after the donor has died, some organs can be donated while the donor is still alive. There are about as many living donors every year as there are deceased. Patients on the waiting list are registered in a national computer network, and when donor organs are identified, the program generates a list of potential recipients ranked by certain criteria. Once you're added to the national waiting list, you may receive an organ quickly or you may wait many years. The average time frame for waiting can be 3 to 5 years at most centers and even longer in some regions of the country. (Source: https://www.organdonor.gov/about/process.html https://www.kidney.org/atoz/content/transplant-waitlist)

HEPATITIS C: Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The virus HCV spreads through contaminated blood. Until recently, Hep C treatment required weekly injections and oral medications, but today chronic HCV is usually curable with oral medications taken every day for two to six months. Signs and symptoms of the virus include but are not limited to; bleeding and bruising easily, poor appetitive, dark-colored urine, itchy skin, swelling in the legs, weight loss, and spiderlike blood vessels on the skin. (Source: https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278)

HEART DISEASE: Heart disease describes a wide range of conditions that affect the heart. Diseases that fall under this umbrella term include blood vessel diseases such as coronary artery disease, heart rhythm
problems or arrhythmias, and heart defects that someone may be born with (congenital heart defects) among other things. The term is often interchangeably used with the term cardiovascular disease. This generally refers to conditions that involve narrowed or blocked up blood vessels that can lead to chest pain, heart attack, or stroke. (Source: https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118)

NEW RESEARCH: Now that there is a cure for Hepatitis C, it has opened up more matches for organ recipients. Previously, in a transplantation situation involving a Hep C donor, nobody would use the organ or they would use a Hep C positive donor in patients that already had Hep C. Now patients who may not test positive for Hep C but have been waitlisted for an organ can receive an organ from a donor who is Hep C positive, and then once the transplant surgery has taken place doctors can then treat and cure the Hep C. This program has been running for over a year now, and with a constant waitlist and shortage of organs, doctors are encouraged by the results and will most likely be expanding beyond just heart and liver transplants. (Source: Jorge Reyes, MD)