Hepatitis C Treatments May Make More Kidneys Viable for Transplant
There are many programs that have been attempted to overcome the shortage of kidneys available for transplant recipients. One of the most promising has been the use of hepatitis C virus (HCV) positive kidneys.
For many years we have used HCV positive kidneys in patients who already had hepatitis C, but because early treatments for HCV were lengthy (6 months or more), had side effects, and were not very effective (working only 60% of the time), these were the only patients who could receive HCV positive organs.
However, with the development of a new generation of HCV treatments- called direct acting anti-viral therapy or DAA- we can now give shorter treatments (12 weeks) that have fewer side effects and are much more effective (95% cure rates). The use of these treatments has decreased the number of transplant recipients who have HCV.
As a result, the few remaining patients who accept an HCV positive kidney have much shorter waiting times before they receive a transplant. In fact, each year, approximately 500 donated kidneys infected with the hepatitis C virus are discarded because we lack suitable recipients.
With the newer DAA treatments being so successful, and fearing to waste the gift of organ donation, transplant centers are now looking at the use of HCV positive organs in selected recipients who have never been exposed to HCV previously. With successful treatment of the hepatitis after transplant, such programs can decrease waiting times and increase survival by providing a safe way to transplant a broader range of kidney recipients.