July 15, 2019
VCU Health is expanding organ access by safely transplanting hepatitis C kidneys
The Hume-Lee Transplant Center protocol significantly shortens the average wait time for a kidney transplant.
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The VCU Health Hume-Lee Transplant Center has developed and studied a unique process that is behind the safe and effective transplantation of hepatitis C kidneys, which expands organ access while also reducing treatment costs for patients.
The clinical research involved transplantation of a deceased donor’s infected kidney into a recipient who does not have hepatitis C. As part of Hume-Lee’s trial protocol, patients receive oral direct-acting anti-viral medication prior to the transplant to prevent the transmission of hepatitis C from the donor to the recipient. This approach has allowed most patients to avoid hepatitis C treatment. Study results showed that after successful treatment there is an extremely low chance of hepatitis C reoccurrence in the recipient’s bloodstream — just 10 percent.
The focus on treatment before receiving a hepatitis C kidney separates the VCU efforts from other protocols. This has been effective in preventing the virus, but also has resulted in a decrease in hepatitis C prevention medication following a transplant, saving patients an average of $40,000 and sparing them the side effects of those treatments. In other protocols, all patients receive a mandatory 12 weeks of anti-viral medications.
The trial, supported by a $45,000 VCU Presidential Research Quest Fund grant, lasted more than a year. During that time, due to agreeing to accept hepatitis C kidneys, the average wait for a transplant was just 33 days. The average wait for a kidney transplant can be three to five years, according to the National Kidney Foundation.
Gaurav Gupta, M.D., medical director of Hume-Lee’s kidney and pancreas transplant program and associate professor of internal medicine and surgery, who also served as the principal investigator for the research study that developed and investigated the protocol, recently presented the VCU team’s research and findings at this year’s American Transplant Congress.
“Our approach was designed with the patient in mind,” Gupta said. “And we have been very successful using organs that at one point would have been discarded and doing so in a way that is safe and effective while also acknowledging costs associated with advanced treatments.”
Hume-Lee physicians confirmed through their research in late 2018 that the use of hepatitis C kidneys is safe, effective and allowed for shorter wait times for patients, affording more people the opportunity to return to a life without dialysis with organs that previously would have been discarded. In January, staff began presenting this as a choice to patients on the transplant center’s waitlist who might benefit.
VCU Health Hume-Lee Transplant Center has transplanted more than 50 kidneys through both efforts. One such patient, Richmond-area transplant recipient Sharon Minor, made national news when she was featured on HBO’s VICE News Tonight in a story titled, “The opioid epidemic has a ‘silver lining’ that’s saving lives.”
“We do this work because it is the right thing to do for our patients. We welcome the opportunity to share our team’s efforts with [the] greater transplant community so even more patients can potentially benefit,” Gupta said.
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