Eight-day treatment could expand access to life-saving organ transplants

Canadian researchers have demonstrated that a short antiviral treatment can allow patients to safely receive organs from donors with hepatitis C, potentially expanding the pool of available organs.

Researchers at Toronto’s University Health Network (UHN) have reported promising results from an eight-day treatment protocol designed to prevent hepatitis C virus (HCV) infection in organ transplant recipients.

Published in The Lancet Gastroenterology & Hepatology, the study examined 116 kidney, lung, heart, pancreas and kidney-pancreas transplant procedures involving organs from donors with active hepatitis C infections.

All recipients received the Toronto HCV Protocol, consisting of one dose of antiviral medication before transplantation, followed by seven days of treatment after surgery.

None of the 116 recipients developed chronic hepatitis C, required additional antiviral treatment or experienced HCV-related complications. All had no detectable HCV infection at their 12-week assessment or last follow-up.

The findings could help address a significant challenge in organ transplantation. Historically, organs from donors with hepatitis C were rarely used for recipients who did not already have the virus.

Although modern antiviral medications have made these transplants possible, conventional treatment typically requires eight to 12 weeks, creating additional costs and potential delays in accessing medication.

The Toronto protocol allows most patients to complete treatment before leaving the hospital.

Researchers also compared outcomes with transplant recipients who received organs from donors without hepatitis C. Survival and organ function were similar between the groups, with two-year overall survival reaching 87.1 per cent among patients treated using the Toronto protocol.

“Our original study showed that this approach could work in 30 patients,” said Dr. Jordan Feld, senior scientist at UHN and senior author of the study. “Now we have shown it can be implemented in routine clinical practice across multiple organ types with excellent long-term outcomes.”

The research could have important implications for Canada’s organ donation system, particularly as the opioid crisis has increased the number of otherwise healthy donor organs testing positive for hepatitis C.

By safely using more donated organs, hospitals may be able to reduce transplant waiting times and improve access to life-saving procedures.

The study was supported by the Canadian Institutes of Health Research and UHN Foundation.

Source: University Health Network (UHN Research).

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