TUESDAY, Sept. 8, 2020 (HealthDay News) — New hepatitis C medications are allowing people to receive a kidney transplant from a deceased donor who had the liver disease — a strategy aimed at getting more lifesaving organs to patients languishing on waitlists.
Two new studies are highlighting the promise of the approach, showing that if patients are given the drug Mavyret, they can safely receive the kidneys and the organs function well.
Experts said the hope is to use some donor kidneys that would otherwise be discarded, and shorten the wait time for some of the thousands of Americans who need a kidney transplant.
“The challenge we have in organ transplantation is the supply doesn’t meet the demand,” said Dr. Matthew Cooper, director of kidney and pancreas transplantation at Medstar Georgetown Transplant Institute, in Washington, D.C.
Close to 100,000 Americans are on the waitlist for a donor kidney, according to the National Kidney Foundation. Yet around 20% of kidneys procured from deceased donors are discarded, said Cooper, who is also on the foundation’s board of directors.
That happens for various reasons, but experts believe more of those rejected kidneys could be transplanted. One recent study, for example, found that people who received donor kidneys with signs of “acute injury” fared just as well as patients who received organs without injury.
Yet transplant centers commonly reject kidneys with acute injury.
One way to address the shortage in donor kidneys, Cooper said, is to figure out how to make better use of the organs that are procured each year.
That’s why, in the past several years, some transplant centers have been using kidneys from deceased donors with hepatitis C.
Hepatitis C is a liver infection that can cause serious chronic disease. In the past, donor organs positive for hepatitis C would be discarded, except in limited circumstances where the recipient also had a history of the infection.
Historically, the drugs used to treat hepatitis C were hard to take and only modestly effective — curing around 40% of patients, and causing flu-like symptoms over the one-year course of treatment.
That has changed in recent years, as a number of new, direct-acting antivirals have been approved.
The new medications are much more effective than the old drugs — with cure rates exceeding 98%, explained Dr. Niraj Desai, senior author on one of the new studies.
They are also far safer, said Desai, who is surgical director of kidney and pancreas transplant at Johns Hopkins Medicine, in Baltimore.
Now the question is how to best refine the course of antiviral treatment: When is the best time to begin, and how long do transplant recipients need to take the medication for it to be effective?
The main issue with the new drugs, Desai pointed out, is their hefty price tag.
He and his colleagues have found that one month of treatment with a drug combination called Mavyret may be enough. They gave 10 transplant recipients the medication — starting just before…