Congratulations to Tarek Alhamad, MD, Assistant Professor of Medicine, Medical Director of Kidney and Pancreas Transplant Programs, Division of Nephrology, who was awarded a $350,000 Clinical Innovation grant from Mid-America Transplant to evaluate the Clinical and Economical Benefits of Organs from Hepatitis C-Positive Donors.
Krista Lentine
Dr. Alhamad, the principal investigator of the grant, will be collaborating with Drs. Krista Lentine, MD, PhD, and Mark Schnitzler, PhD, at St. Louis University, and David Axelrod, MD, MBA, at the Lahey Hospital and Medical Clinic, MA.
There is a critical shortage of organs available for kidney, liver, heart and lung transplantation, and an ever-increasing waiting time for the organ transplantation. In 2013, the waiting time for a kidney transplant was 1-3 years; currently, the local waiting time is approximately 3-5 years.
Because of the shortage in organs and lengthy waiting times, there is an increased interest in “non-standard” organs, such as those from patients infected with hepatitis C virus (DHCV+). These organs are generally not considered for transplantation, despite favorable donor characteristics.
The use of Direct Acting Antiviral (DAA) agents, however, could change the acceptability of DHCV+ organs for transplantation. DAAs are effective, even in patients with advanced liver and kidney diseases, or after liver or kidney transplant.
David Axelrod, MD, MBA
“With the introduction of DAA agents, which offer more than a 95% cure rate for hepatitis C, we need to change the culture of discarding such valuable organs,” says Dr. Alhamad.
Drs. Alhamad and Lentine will conduct a comprehensive assessment of the benefits of DHCV+ organ transplantation. They will examine the discard rate of DHCV+ organs over time, evaluating patient acceptability of such organs, quantifying the cost and patient/graft survival after DHCV+ transplant, and determining the reduction in waiting times needed to offset the risk of DHCV+ transplant and cost of DAA therapy.
Mark Schnitzler, PhD
“This grant will pave the road for utilizing these organs by quantifying the clinical and economic benefits of expanding the organ pool through transplantation of DHCV+ organs into hepatitis C negative recipients, followed by DAA treatment,” says Alhamad.
This project has the potential to improve patient care by developing accurate donor quality scores that no longer include hepatitis C status, which will reduce barriers to broader organ utilization.
The study also aims to improve educational tools that will better inform patients and referring providers of the benefits and risk of accepting these organs and will demonstrate that DHCV+ organ transplantation is cost-effective despite the need for post-transplant DAA therapy to prevent infection.