B.C. Transplant says it is considering the previously unthinkable: allowing the transplantation of organs infected with hepatitis C into those who could die while waiting for kidneys, lungs or other organs.
“I am cautiously, optimistically, encouraged,” said Dr. David Landsberg, provincial medical director, transplant services. He was referring to the stunning announcement last week about a Toronto pilot study. Surgeons said that in 11 patients so far, they had used lungs from deceased donors with hepatitis C to transplant into patients who needed the organs to survive.
“It’s all because of the drugs,” Landsberg said, referring to direct antiviral pills that can reportedly cure the disease in about 12 weeks in more than 90 per cent of patients prescribed the $20,000 medication. (Repeat infections can occur, however, since there is no residual immunity even after treatment is completed.)
In the ongoing Toronto trial protocol, donor lungs are removed and then immersed in a special solution for about six hours, during which time doctors assess their condition. In a process called ex-vivo lung perfusion, developed at Toronto General Hospital, about 85 per cent of the blood carrying the virus is removed before the lungs are transplanted into recipients.
Within a month after the operation, recipients are tested for hepatitis C and if positive, they are started on drug treatment to prevent infection of the liver where the virus typically resides. Without treatment, those infected with hepatitis C are at risk of getting liver cancer or cirrhosis.
Dr. Jordan Feld, a liver specialist and co-investigator of the Toronto trial, said the research there was initiated because of the rising number of organ donors who were observed to be hepatitis C positive. He said while there are obvious concerns about potentially infecting recipients, the results so far show that because of the new medical treatment, it is a …read more
Source:: Vancouver Sun