New hepatitis drugs could cut wait time for kidney transplants

When the estimated wait for a donor kidney stretched from four years to five, and then from five to eight, C.J. Dabney started to fear that he would die before getting a transplant. So he didn't need convincing earlier this year when doctors offered a radical new alternative — a kidney infected with hepatitis C.

"I'm in," he said.

On Friday Dabney, 54, became the first patient in Minnesota to receive a kidney from a donor who was carrying the virus.

"Five years ago, this would have been impossible to do," said Dr. Jeffrey Wang, the nephrologist who recommended the procedure. The difference is new drug therapies that are curing what was previously a chronic infection, making the organs safe for transplant by healing the kidney's recipient.

Wang and transplant specialists at HCMC in Minneapolis said they hope the development can reduce waiting times that have sometimes amounted to a death sentence for patients with kidney failure. In Minnesota alone, 2,160 people are awaiting kidney transplants, and 704 have been waiting at least three years. Last year, 93 people on Minnesota's list died awaiting transplant, and another 74 were removed from the list because they had become too sick.

"This opens up a whole new group of donors," said Dr. Paul Stahler, who performed Dabney's transplant at HCMC.

The nation's opioid crisis, sadly, has increased the opportunity for organ procurement, Stahler said, because many overdose victims are young and have organs that are stronger and ideal for transplant. But many also suffered hepatitis C infections, often due to shared use of needles, that prevented organ donation until now.

While many screening criteria can rule out organs as unfit for transplant, hepatitis C has been a significant one because it is a leading cause of liver failure and transplants itself.

Now that drugs can treat the infection, kidney transplant centers see the hepatitis C population as a promising resource. It's not clear how many donor kidneys might become available as a result, but as many as 350,000 Americans have chronic forms of the infection, though an estimated half don't know they are infected due to their lack of initial symptoms.

Without this new option, Dabney might have waited years longer due to his health status and blood type, Wang said. "The waiting time reduction [for others] could be pretty significant. It could be years we shave off."

Other transplant centers in Minnesota already have used hearts and livers infected with hepatitis C, he added.

The HCMC surgery came two weeks after the Trump administration announced a national campaign to reduce cases of kidney failure and improve treatment. One White House goal is to double the number of kidneys available for transplant by 2030.

Dabney went to a retail clinic five years ago with flu-like symptoms, but he was referred to a hospital for emergency care due to extremely high blood pressure. To his surprise, doctors found he had the most severe form of kidney disease, stage five, meaning that his organs were no longer filtering blood and that he would need a transplant or dialysis treatments to survive.

"That came out of the blue," said Dabney, who had worked hard through diet and exercise to cut his weight from 360 pounds to 180.

Multiple dialysis treatments each week left him exhausted, and he had to quit work as a real estate agent. While dialysis kept him alive, he dreamed of a chance to get rid of the time-consuming and exhausting treatments.

Recovering at HCMC on Monday, Dabney said he's glad he consented to the transplant and hopes his case inspires others. He was discharged from the hospital later that night, and on Tuesday he received the antiviral drugs to treat the hepatitis C in his new kidney.

"I'm taking 18 pills already, two times a day," he said, referring to medications that suppress his immune system so his body accepts the new kidney. "What's three more?"

Dabney looked up an online support group and found that many transplant recipients name their kidneys. He thought carefully given his unique circumstances, and he chose Phoenix — the name of a mythical bird — for the infected organ he received from a deceased donor.

In the old stories, the bird "rises from the ashes," Dabney said. "It's reborn."

Jeremy Olson • 612-673-7744