PHILADELPHIA — A new Penn Medicine study of data from the national transplant registry found that kidneys from donors with the hepatitis C virus functioned just as well as uninfected kidneys during the year after transplant.
The analysis of data from between April 2015 and March 2019 was published Thursday in the Journal of the American Society of Nephrology.
“The way we use kidneys has taken a 180-degree turn,” said Vishnu Potluri, a nephrology fellow at the University of Pennsylvania and the study’s lead author.
About 2.4 million people in the United States have hepatitis C, which today is largely associated with sharing needles. Before 1992, when improved testing became available, people also contracted hepatitis C when they received donated blood, blood products, and organs that were infected.
Before September 2018, kidneys infected by the hepatitis C virus were transplanted only into patients who already had the infection.
In 2015, new antiviral treatments became available for hepatitis C. Yet, there were still a large number of hepatitis C-infected organs that were being discarded, Potluri said.
New hepatitis C drugs mean diseased organs can be used for transplants. In the last year, about 75% of the infected kidneys were being transplanted into patients who did not have the virus, researchers found.
“Hepatitis C kidneys work just as well,” he said. “The reality is that once the infection is gone, the hepatitis C should be gone.”
Now, the stigma of using an infected kidney has been reduced as more patients and transplant centers use the infected organs knowing the patients will be cured, Potluri said.
Researchers looked at sets of donors matched for qualities such as age, weight, and history of high blood pressure, but one group had the hepatitis C virus and the other did not. After the transplants, they then used a mathematical formula to estimate how well blood was filtered by kidneys. They found that after one year, both sets of recipients had similar results.
Steven Denise, of Rye Brook, N.Y., was one of those patients.
Two years ago, Denise could barely walk from the beach to his summer house in Ventnor. The normally active 64-year-old financial planner was exhausted, freezing cold, and had trouble sleeping.
Denise’s creatinine level — an indicator of how well the kidneys are filtering waste from the blood — was so high, he was in advanced kidney failure.
“I was basically dead,” Denise said.
He spent the next eight months on dialysis — five days a week for five hours each time. Friends, relatives and even strangers offered to donate a kidney, but none were a match. He visited four hospitals to get on transplant waiting lists. About 90,000 Americans are waiting for kidney transplants, which can take about three to five years, according to the National Kidney Foundation.
During a trip to the University of Pennsylvania for pre-transplant testing, he was offered a place in a clinical trial that used hepatitis C-infected kidneys along with Zepatier, an antiviral drug made by Merck, that is used to cure the virus in people who were not infected before transplant.
Denise jumped at the chance.
Less than a week later, he received a kidney. After two weeks of treatment for hepatitis C — a bloodborne virus that affects the liver — there was no detectable virus, he said.
Two years later, Denise works part time and is making plans to travel to Florida and Italy with his wife. He takes daily anti-rejection drugs and insulin for diabetes and goes for regular blood tests and follow-up appointments.
Denise is forever grateful to the donor — a 34-year-old man who suffered a brain aneurysm — and his family. He also has no regrets entering the clinical trial for a hepatitis C-infected kidney and would recommend it to anyone on dialysis, he said.
“In two weeks, I was completely cured,” Denise said.
The new study looked at data from only one year after transplant, so now the researchers are working to see what the outcomes are at five years, Potluri said.
For Potluri, whose father has kidney disease, the outcomes are especially encouraging.
“I would absolutely give my own father one of these kidneys,” Potluri said.
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