Bashar A. Aqel, M.D., a transplant hepatologist at Mayo Clinic in Arizona, discusses ways to expand the potential donor pool and shorten the wait time to transplant for patients with end-stage liver disease. Mayo Clinic transplant hepatologists and surgeons led a multisite, prospective observational study of liver transplant using allografts from donors with hepatitis C virus for recipients who are HCV-seronegative. Outcomes proved positive and our transplant experts have now expanded these protocols for other organs such as the kidney and heart.
Learn more about how hepatitis C organs are now usable for transplant
Refer a patient Mhm. Hepatitis C in general affects deliver predominantly and in the absence of good treatment it can cause liver damage, liver cirrhosis and may cause as well liver cancer in the transplant community. We've been thinking outside the box, we're trying to deliver transplant to more patients despite some record number of transplants over the past two years, the number of people needing transplant continues to increase and we are not meeting the demand with that in mind. And thinking about expanding the donor pool. We thought of accepting donors from people with Hepatitis C infection. We put in place a system so that the treatment can be initiated promptly after transplant So that we can achieve the cure within the shortest period possible. Fast forward. Now over the past two years, more than 200 lives were saved. Using those organs the power of the Mayo Clinic enterprise with three transplant center has been able to show that those organs can be used safely. The patients were treated promptly after transplant and every patient was cured from that infection. That's really the experience that we had so far and clearly has allowed us to expand the donor pool and deliver transplant to a lot of patients who are in urgent need for transplantation, expanding the donor pool and accepting hepatitis C positive donors and patients awaiting liver transplant. We decided to expand that to other organs, including kidney heart and lung transplantation as well. And we adopted the same practice. We combined the effective antiviral therapy with a lipid lowering agent that we thought will help prevent the Hepatitis C from entering into the cells. That combination was given to the recipient before they go to surgery, where they are accepting a liver from somebody with hepatitis C. And rather than treating for 12 weeks, we treated for only one week. So the recipient was treated with eight days. We have been able to prevent and cure the infection in 100% of those recipients with only Eight days of therapy compared to the 12 weeks of therapy that we have used previously. We have adopted this practice in recipients of non liver solid organ transplant recipients. But we are working on research to adopt the same preemptive strategy in recipients of liver transplants from donors with chronic hepatitis. We are not only using antiviral therapy but we are combining antiviral therapy with a lipid lowering agent. That lipid lowering agent, combined with the antiviral therapy is preventing the hepatitis C from entering into the recipient cells. Being a leader in the transplant field and having converged protocol across the enterprise clearly is giving us the ability to conduct research in the field of transplantation