Organs infected with the hepatitis C virus are being used more and more for transplantation.
Unthinkable until a few years ago, the practice of putting hepatitis C-infected organs into uninfected patients has been embraced by the transplant world as a way to whittle long waiting lists for lifesaving kidneys, livers, hearts, and lungs.
The main reason for this about-face is simple: New, easy-to-tolerate antiviral drugs with better than 95 percent effectiveness have transformed the treatment of hepatitis C, a virus that can slowly destroy the liver. A small but growing body of research by the University of Pennsylvania and other pioneers shows these medications can cure hep C infection in transplant patients who accept infected organs, typically with just four to 12 weeks of therapy. At the same time, the opioid crisis has meant there are more organs available from people with hep C, which can be spread by the use of injection drugs.
Now, the question is whether this approach should continue to be studied in clinical trials, or opened right away to the 114,000 Americans awaiting transplants. Patients are told about the potential risks of accepting organs with the virus and do not lose their place on transplant lists if they decline.
At least one transplant center, at the University of Washington, is not holding off. It announced in June that all heart transplant patients will be offered suitable hearts from hep C-infected donors. Infected hearts may eventually account for as many as eight of the 48 heart transplants UW Medicine performs annually, it said in a news release.
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