As Opioid Crisis Continues, More Donor Organs Carry Hepatitis C
Add another hardship to the many already triggered by the opioid epidemic: More donated organs infected with the hepatitis C virus.
"The ongoing U.S. opioid crisis has resulted in an increase in drug overdose deaths and acute hepatitis C virus infections, with young persons (who might be eligible organ donors) most affected," explained a team led by Dr. Winston Abara. He's a hepatitis researcher at the U.S. Centers for Disease Control and Prevention.
Between 2010 and 2017, the number of organs obtained from so-called "increased risk" donors -- people at risk of carrying hepatitis due to behaviors such as drug abuse -- tripled, the new study found.
In 2010, about 9 percent of donor organs came from these at-risk individuals, but seven years later that number had already risen to more than 26 percent, Abara's team reported.
The number of organs obtained from people who died from "drug intoxication" also tripled, from just over 4 percent in 2010 to just over 13 percent by 2017, the CDC researchers said. Organ donor deaths tied to injected drugs (such as heroin), specifically, rose fivefold over the same period, they added.
All of this is cause for concern, since tainted needles are a prime conduit for infection with hepatitis C, which can trigger potentially fatal liver disease over time.
Still, advances in medical care mean that many hepatitis-infected donor kidneys, livers and other organs could be lifesavers for the thousands of Americans on transplant waiting lists.
That's because powerful new medicines that rid the body of hepatitis C can render the transplant viable, Abara's group said.
Recipients in need of an organ could be "screened post-transplant and, if hepatitis C infection is diagnosed, offered treatment," the study authors explained.
Liver specialist Dr. David Bernstein agreed.
"Highly effective, direct-acting antiviral therapies have led to almost universal cure of hepatitis C infection," noted Bernstein, who is chief of hepatology at Northwell Health in Manhasset, N.Y.
These drugs include powerful, but expensive, medicines -- such as Sovaldi (sofosbuvir) and Harvoni (ledipasvir/sofosbuvir) -- which can clear hepatitis C from the body in a matter of months.
With more hepatitis-infected organs now in the transplant pipeline, the advent of these drugs has "led to the use of these hepatitis C donor organs being placed into hepatitis C-negative recipients, especially in solid organ transplants such as kidney, heart and liver," Bernstein said.
Once the recipient receives the infected organ, they are typically given one of these medicines, with "the result being universal cure," he said. "This has allowed more patients awaiting organ transplantations to receive the lifesaving treatment that they need."
However, understanding the presence of addiction in a deceased donor's history, and screening donated organs for hepatitis, remains essential.
With that knowledge in place, "recipients and their clinicians can [then] be notified and patients can be appropriately screened post-transplant," the CDC team wrote.
The findings were published Jan. 25 in the CDC's Morbidity and Mortality Weekly Report.
There's more on organ donation and transplant at organdonor.gov.
SOURCES: David Bernstein, M.D., vice chair, medicine for clinical trials, and chief, hepatology, Northwell Health, Manhasset, N.Y.; Jan. 25, 2019, Morbidity and Mortality Weekly Report