Organs from patients with hepatitis C could be SAFE

People with hepatitis C may be able to donate their organs without the risk of the virus spreading, a study suggests. 

Currently, organs from patients with the infection can only be transferred to people who already have the virus to avoid it being passed on. 

But researchers have now discovered a way to clear recipients of the virus within days of being given infected organs. 

Volunteers took a combination of antiviral and cholesterol-lowering drugs 12 hours before surgery and then daily for a week after the operation.   

While some had measurable levels of hepatitis C in their blood initially, by the end of the seven days their bodies had fended off the virus. 

University of Toronto Scientists say the discovery could offer a ‘huge benefit’, raising  hopes that tens of lives could be spared.

A new study, by Canadian researchers, has found giving uninfected recipients antiviral and cholesterol-lowering drugs prevents them from contracting hepatitis C during organ transplants (file image)

A new study, by Canadian researchers, has found giving uninfected recipients antiviral and cholesterol-lowering drugs prevents them from contracting hepatitis C during organ transplants (file image)

There are more than 6,000 people on the UK Transplant Waiting List – 400 of which die each year waiting for an organ.

Up to 15 suitable donors are declined every year because of the risk of transmission of hepatitis C, figures show. 

Hepatitis C, most commonly acquired through infected blood, inflames the liver. If left untreated, it can cause cirrhosis – or scarring of the liver. 

This can cause it to stop working properly over time. In severe cases, life-threatening problems such as liver failure or cancer can develop.

But with modern treatments, it’s possible to clear the infection with relative ease, and most people who contract it will have a normal life expectancy.  

Eleven recipients received organs – including lungs, kidneys, hearts, as well as a kidney and pancreas – from nine hepatitis C-positive donors.

Six to 12 hours before the operation, they were given antiviral drugs glecaprevir or pibrentasvir and ezetimibe, a cholesterol-lowering drug.

WHAT IS HEPATITIS C?  

Hepatitis C is inflammation of the liver and there is no preventive vaccine.

There are around three million people in the US and 215,000 people in the UK who are living with chronic hepatitis.

Most aren’t aware that they are infected, according to the Centers for Disease Control and Prevention (CDC). 

Spread through contaminated blood, hepatitis C tends to develop into a chronic infection after six months.

The infection attacks the liver, leading to cirrhosis or liver cancer.

 Symptoms include:

  • Weight loss (without trying) 
  • Loss of appetite 
  • Feeling very full after a small meal 
  • Nausea or vomiting 
  • An enlarged liver, felt as a mass under the ribs on the right side 
  • An enlarged spleen, felt as a mass under the ribs on the left side 
  • Pain in the abdomen or near the right shoulder blade 
  • Swelling or fluid build-up in the abdomen 
  • Itching 
  • Yellowing of the skin and eyes (jaundice)

They were then given the same treatment daily for seven days. 

Six recipients had detectable but unquantifiable hepatitis C levels a day after the operation. 

All of the patients were cleared of the virus by day five. They all remained free 10 weeks later at a follow-up. 

Four recipients developed a quantifiable presence of hepatitis C in their blood after the transplant. 

But it declined rapidly and was unquantifiable by the fourth post-op day in all four patients. They, too, remained virus-free after 10 weeks. 

One lung transplantation patient died during that time of sepsis, but it was unrelated to the operation, the researchers said. 

Cholesterol is needed for viruses to grow and limiting its production curbs the opportunity for hepatitis C to thrive, scientists say.

The findings were presented this week at The Liver Meeting 2019 in Boston – held by the American Association for the Study of Liver Diseases.

It’s estimated around 215,000 people in the UK have hepatitis C. Figures show there are around three million patients in the US.

The virus killed 1.34million people in 2016 alone – 140,000 more than tuberculosis, 340,000 more than HIV and 621,000 more than malaria. 

Lead author Dr Jordan Feld, chair in translational liver disease research at the University of Toronto, said:  ‘Transplant recipients are understandably nervous about accepting organs from people with HCV infection.

‘This very short therapy allows them to leave hospital free of HCV, which is a huge benefit.

‘Not only is it cheaper and likely safer, but the patients really prefer not having to worry about HCV with all of the other challenges after a transplant.’ 

‘By adding an entry inhibitor and preloading the liver with DAAs [antiviral drugs], we thought that treatment could be significantly shortened and our data support that that is indeed the case.’   

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