Hepatitis C, the top reason for a liver transplant, could be considered a ‘rare disease’ by 2030
April is organ donation month and two guests joined St. Louis on the Air to discuss new advances in the field of organ donation research.
Nationwide, there are hundreds of thousands on various waiting lists for organ transplants. In the St. Louis area, there 200-250 patients waiting for a liver transplant and 1,300 patients waiting for a kidney transplant.
The guests also discussed the importance of organ donation, signing up to donate while living and also after death. Here’s who joined us for the discussion:
- Bruce Bacon, M.D., Director of the Center for Transplantation, SLUCare and SSM Health Saint Louis University Hospital
- Krista Lentine, M.D., Ph.D., Director of Living Donation, SSM Health Saint Louis University Hospital; SLUCare Nephrologist
Here are three news things we learned about organ donation since dispelling common myths on the show last year.
1. Live donor transplants can be successful for formerly incompatible patients
For years, patients with high levels of pre-formed antibody in their blood faced unique barriers to acquiring a transplant. In recent years, steps have been taken to bring down those barriers. One such effort is called paired donor exchange and it helps patients with a willing living donor that is incompatible with their type to enter into an exchange to find a donor with an organ that matches their needs. The other effort is an incompatible live donor transplant, which gives the patient treatments to suppress the immune system to erase the pre-formed antibody and make the organ transplant compatible.
A recent article in the New England Journal of Medicine showed that a kidney transplant to an incompatible patient had a high survival rate over the course of eight years.
2. Recently, an HIV-positive patient donated an organ to an HIV-positive recipient
In March, two successful transplant surgeries (liver, kidney) were performed by transplanting HIV-positive organs to HIV-positive patients.
“That’s a result of a change in legislation,” said Lentine. “Previously, legislation prohibited procurement of HIV-positive organs but legislation went forward, the HOPE Act, that allows those transplants to go forward. They are high-risk transplants, but they are legal now.”
3. Hepatitis C, the top reason for a liver transplant, could be considered a 'rare disease' by 2030
“In liver disease, the explosion that is going on is the development of new therapies for new treatment of Hepatitis C,” said Bacon. “The common reason that people come to end-stage liver disease and require a liver transplant are chronic conditions due to Hepatitis C. What we have now, and for about the last two years, is oral therapies without any side effects for just 12 weeks that cure 95 percent of patients. Cure. Not just repress, but cure patients with Hepatitis C. Our liver group has treated about 2,000 patients and has cured about 1,950 of those patients. Eventually, the need for transplant to take care of complications due to Hepatitis C will fade away.”
Right now, the oral therapy for Hepatitis C is relatively expensive (it started at $1000 per pill) but Bacon said that the price is starting to come down and pharmaceutical companies are competing to push it down further.
Bacon said the ultimate in treatment is prevention. There are still reasons why a liver transplant would be needed—overuse of alcohol, autoimmune and inherited diseases—but the single largest reason liver transplants are needed has taken a hit.
“It is estimated that where we are with screening techniques to identify patients who need treatment and the successful treatment, that in 15-20 years, Hepatitis C will be considered a ‘rare disease’ in America,” Bacon said.
Want more information on transplantation? Check out this website from St. Louis University.
St. Louis on the Air brings you the stories of St. Louis and the people who live, work and create in our region. St. Louis on the Air host Don Marsh and producers Mary Edwards, Alex Heuer and Kelly Moffitt give you the information you need to make informed decisions and stay in touch with our diverse and vibrant St. Louis region.