Transplanting organs from hepatitis C-positive donors decreases wait time for recipients

Doctors at UAB are now able to safely transplant organs from hepatitis C-positive donors into uninfected recipients and then treat the patients with antiviral therapy.

Doctor And Nurse Suture Patient In Emergency RoomDoctors at UAB are now able to safely transplant organs from hepatitis C-positive donors into uninfected recipients and then treat the patients with antiviral therapy.Four years ago, 28-year-old Ana Kenney was told that she would either spend the rest of her life on dialysis or have to wait up to 10 years for a kidney transplant.  

Today, she has a working kidney and is off dialysis, thanks to a new organ transplant program at the University of Alabama at Birmingham. Doctors at UAB are now able to safely transplant organs from hepatitis C-positive donors into uninfected recipients and then cure the hepatitis C with antiviral therapy.  

This has allowed more organs to be transplanted, helping patients get transplanted sooner and enabling more people to lead healthier and longer lives. In the past, organs from hepatitis C-positive donors were available only for hepatitis C-positive recipients, which led to many organs being discarded as they could not be used.

“The shortage of organs is a major impediment in access to lifesaving therapy of transplantation in patients with end-stage organ failure,” said Shikha Mehta, M.D., a nephrologist who specializes in kidney transplantation in the Division of Nephrology at UAB. “About 18 patients die each day waiting for an organ transplant. As a sad and unintended consequence of the opioid epidemic, there is an increased availability of hepatitis C-positive organs. Our new program helps combat the organ shortage and provides improved access to transplantation by using this pool of organs. With advances in therapy for hepatitis C and transplantation, organs from hepatitis C-positive donors can be safely used for transplant in patients waiting on the long list for organ transplant.”  

“With so many people in need of an organ transplant, we simply cannot discard otherwise usable organs that offer our patients improved survival and quality of life,” said Babak Orandi, M.D., Ph.D., a surgeon in the Division of Transplantation who specializes in liver, kidney and pancreas transplants. “Now that the treatment for hepatitis C is simple, well-tolerated, reliably effective and needed for only a short period of time, organs from donors with hepatitis C are a great option to get patients transplanted sooner to prevent them from dying on the waiting list.”

In October, UAB began transplanting kidneys and livers from infected donors into uninfected patients. The recipients are told ahead of time that the organ is from a hepatitis C-positive donor and that they will have to be treated for the illness after the transplant. If the patient agrees to accept an organ from a hepatitis C-infected donor, the transplant candidate will receive the transplant and immediately start the three-month treatment.  

Kenney, who was born with one kidney and later learned that it was no longer working, says receiving the new organ has changed her life since she was diagnosed with kidney failure in 2016.  

Ana Kenney kidney transplant recipientAna Kenney received her kidney on Nov. 12 at UAB Hospital. CREDIT: Ana Kenney“I used to have to be on dialysis for eight hours, seven days a week. That lasted for three and a half years, and it dictated my schedule and my family’s schedule,” Kenney said. “I would wake up early to start the dialysis before my kids woke up, then I had to be in bed by 8 or 8:30 each night so I could finish the dialysis.”

Kenney was contacted by UAB in October and was asked if she would be willing to receive an organ from a hepatitis C-positive donor. She agreed, and a few weeks later on Nov. 11, Kenney received a call that a kidney was available. Her kidney transplant surgery took place the next day.

“I can stay up late again. I can have late nights with my husband. I can have sleepovers with my kids again where we put blankets in our living room and stay up watching movies and eating popcorn. I can go out with my family and we no longer have to be home by 8:30 or 9 p.m. so I can plug into the dialysis machine,” Kenney explained.

Since October, UAB has transplanted 25 kidneys, and as of November, the hospital has transplanted 13 livers from hepatitis C-positive donors to hepatitis-C negative recipients.  

“There are more than 112,000 people in the United States who are currently waiting for an organ transplant, but there are not enough donors available to meet that need,” Orandi said. “By using organs that might have been discarded in the past simply because the donor had hepatitis C, we can help more people achieve the benefits of transplantation.”  

Physicians plan to begin transplanting hearts and lungs from hepatitis C-infected donors in the future.