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A faster transplant, but a kidney with hepatitis

Irma Hendricks, with her grandson, C.J., at her home in East Stroudsburg, received a kidney transplant from a donor with hepatitis C, and took medication after surgery that cleared away the virus and left her feeling healthy again. Hendricks is part of a pilot study testing if new drugs that promise to cure most hepatitis C could speed transplant rates.
Centers bet on new medication

WASHINGTON — A bold experiment is giving some patients a chance at cutting years off their wait for a kidney transplant if they agree to a drastic-sounding option — getting an organ almost sure to infect them with hepatitis C.

Betting on new medications that promise to cure hepatitis C, two leading transplant centers aim to use organs that today go to waste, a bid to put a dent in the nation’s long transplant waiting list.

Pilot studies are underway at the University of Pennsylvania and Johns Hopkins University to test transplanting kidneys from deceased donors with hepatitis C into recipients who don’t already have that virus. If the groundbreaking research eventually pans out, hundreds more kidneys — and maybe some hearts and lungs, too — could be transplanted every year.

“We always dreaded hepatitis C,” said Dr. Peter Reese, a Penn kidney specialist who is helping lead the research.

“But now hepatitis C is just a different disease,” enough to consider what he calls the trade-off of getting a new kidney years faster but one that comes with a hopefully treatable infection.

It’s a trade-off prompted by an organ shortage. More than 99,000 people are on the national kidney waiting list, but only about 17,000 people a year get a transplant and 4 percent a year die waiting, according to the United Network for Organ Sharing (UNOS).

“If we had enough organs, we wouldn’t do this,” said Dr. Niraj Desai, who is leading the Hopkins study. But, Desai said, “most patients are pretty open to the idea once they hear what the alternatives are.”

Doctors had told 66-year-old Irma Hendricks of East Stroudsburg to expect at least a five-year wait for a kidney transplant. Dialysis three times a week was keeping her alive, but leaving her with no energy for even routine activities. “I call it the zombie syndrome,” she said.

She jumped at the chance to enroll in Penn’s study, even though doctors made clear they hoped for but couldn’t guarantee a hepatitis cure.

“My son said, ‘Mom, this is a no-brainer. Just do it,’” Hendricks said.

She swallowed an anti-hepatitis pill daily for three months, in addition to the usual post-transplant medications. Testing showed the drugs rapidly cleared hepatitis C out of her bloodstream. With her new kidney functioning well, she now has enough energy to play with her toddler grandson.

“This is giving people in my situation new hope,” Hendricks said.

Kidney transplant specialists are closely watching the research.

Hepatitis C is a simmering infection that, if untreated, over two to three decades can quietly destroy someone’s liver.

At least 2.7 million people in the United States have chronic hepatitis C.

Until a few years ago, it was treatable only by medications with grueling side effects and poor cure rates. Now, breakthrough drugs promise to cure 95 percent of hepatitis C cases with fewer side effects — for people who can afford them. Treatment costs tens of thousands of dollars.

Normally, hepatitis C-infected organs are transplanted only into patients who already have hepatitis C themselves, so as not to further spread the virus.

The opioid epidemic is prompting a jump in donations from people who died of drug overdoses — typically young organs that, absent an infection risk, would be sought after.

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