Around the country, physicians have begun transplanting HIV-positive organs into HIV-positive patients, thanks to the reversal in 2013 of a 1998 law that banned their use. And it has become standard for transplant centers to give hep C–positive organs to patients who already have a hep C infection. Now doctors have crossed a medical threshold—and an ethical one: giving infected kidneys and livers to people who had no trace of hep C to help them get an organ sooner.
The shift is being made possible by powerful drugs approved in the past few years that can cure hepatitis C with a success rate exceeding 95%. “We probably feel the way doctors felt when penicillin was invented,” said Dr. Samuel Sigal, liver specialist at Montefiore Health System. “Hepatitis C therapy should be considered one of the miracles of medicine.”
One reason that more hep C–positive organs are becoming available is that many of the people who once had the disease and might have accepted an infected organ have dropped off that list because so many of them are now cured. Another factor in the supply of infected organs is the surge in the numbers of otherwise healthy younger people dying from drug abuse, particularly of opioids. Some of those individuals contracted hep C from sharing dirty needles.
The United Network for Organ Sharing said drug-intoxication deaths accounted for 34% of transplanted donor hearts and 21% of transplanted donor livers in New York state alone last year. A January report from the American Society of Transplantation said the use of hep C–infected organs could “result in an increase in transplants and lives saved for patients with end-stage organ failure.” The group noted that there could be 300 to 500 opportunities nationwide for donation among hep C–positive people who died of drug-related causes.
“Opioid overdose is a major cause of death in America right now,” said Dr. Tia Powell, who heads up Montefiore’s Center for Bioethics. “There will be some organs available for transplant, and if they are organs with hepatitis C, I hope they’ll be able to do some good.”
Read the full article, including ethical considerations, risks and benefits at http://www.crainsnewyork.com/article/20170723/HEALTH_CARE/170729957/could-hep-c-infected-livers-solve-new-yorks-organ-donor-shortageShare