 – According to Stephen Guy, M.D., transplant surgeon at the Saint Barnabas Health Care System Renal and Pancreas Transplant Centers, if a transplant candidate is found to have hepatitis C, efforts are made to put the disease in remission and then transplant a kidney from an individual who has also been exposed to the virus.
More than 1,200 individuals in New Jersey were diagnosed with hepatitis C (HCV) in 2001. Primarily transmitted through blood products, this viral infection can cause severe liver disease and was the reason for more than 40 percent of liver transplants performed in the state in 2000. Despite the serious implications, infection with HCV alone does not prevent someone from receiving a kidney transplant.
"The risk of patients contracting hepatitis C through dialysis has been reduced to almost zero," says Stephen Guy, M.D., transplant surgeon at the Saint Barnabas Health Care System Renal and Pancreas Transplant Centers. "Disposable fittings for dialysis instruments ensure that blood fluids are not exchanged during the procedure. Likewise, the development of medications that stimulate the bone marrow to produce red blood cells have replaced the need for repeated blood transfusions once common for people with renal disease," he adds.
"For those who have been exposed to HCV, it is an insidious disease that may take many years to cause symptoms," explains Dr. Guy. "Everyone seeking an organ transplant is tested for HCV." Some people who have been exposed to the virus may have active viral disease; others merely have the antibodies to fight the disease that are evidence of a previous infection. In either case, patients may still be eligible for a kidney transplant.
"We now have reliable treatments that can put hepatitis C in remission," says Dr. Guy. "Once the infection is controlled and it is determined that there is no significant liver damage, the patient can proceed to be listed as a kidney transplant candidate." Dr. Guy notes that the immunosuppressive medications taken after transplantation can cause a dormant hepatitis virus to blossom, however, the episode may be temporary.
The good news for people whose active HCV infection resists treatment is that they can be transplanted with an organ donated by someone who has also been exposed to the disease. Sophisticated blood screening tests refined in the early 1990’s are used to identify the hepatitis C virus in donors as well as recipients.
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