UPMC kidney transplant program shut down

By Andrew Shull

UPMC’s living-donor kidney transplant program will likely reopen soon, after it voluntarily… UPMC’s living-donor kidney transplant program will likely reopen soon, after it voluntarily shut down after a recipient received a kidney infected with hepatitis C.

The living-donor program has been shut down since May 12 so that the hospital, the United Network for Organ Sharing and the Pennsylvania Department of Health can investigate the matter further and look into how the patient got an infected kidney as a transplant organ .

Jennifer Yates, a UPMC spokesperson, said that UPMC officials expect live donations to resume “in the very near term,” but they have no exact timetable for it.

“This temporary suspension of the program allows us to thoroughly evaluate our protocols and donor screening processes to reassure our patients that they receive the very highest standards of care,” Yates said in a statement.  

Brandi Hunter-Davenport, the deputy press secretary at the state Department of Health, said that the department was made aware of the situation at UPMC, is investigating and will release the findings of the investigation on its website when the investigation is complete. Hunter-Davenport couldn’t provide any further information.

Anne Paschke, a spokesperson for the United Network for Organ Sharing,a private, nonprofit organization that manages the nation’s organ transplant system under contract with the federal government, said that in situations like this, the network would only make information available if its Disease Transmission Advisory Committee decided to put a hospital on probation or, more seriously, deem it to be a “member not in good standing.” She said that the network would not confirm the existence of, or comment on, any investigations.

And while Paschke did say that cases like this are rare, they are not unprecedented.

According to data provided by Paschke, from 2005 to 2010 there were a total of nine confirmed reports of hepatitis C transmission from organ donations, one of which resulted in a patient’s death.  

Paschke also said that there is no national standard for testing transplant organs for infectious diseases. While the United Network for Organ Sharing has guidelines, each hospital sets its own standards.

According to the UPMC website, there is a shortage of donated kidneys, which prolongs the wait period for recipients.

There are currently 79,000 people who are waiting for a kidney donation, according to the website. UPMC has performed over 600 live-donor kidney donations since that form of kidney donation was made available to the hospital in 2002.

Donated kidneys can come from two different sources, living and deceased donors. According to the website, live donors’ kidneys have a higher success rate in the receiver of the organ than kidneys from deceased donors.

The Hhpatitis C-infected kidney came from a live donor, Yates said.  

UPMC’s website details the screening processes for donors. In addition to screening for infectious diseases, patients will also undergo a physical examination, a review of medicines they are taking, blood tests, tissue typing, an electrocardiogram, chest X-rays and even psychological counseling.

This screening process makes the situation at UPMC a very rare one. The UPMC website for living-donor kidney transplantation explicitly mentions that the medical center screens for HIV and hepatitis.

Sue Simon, the President of the Hepatitis C Association, a nonprofit organization dedicated to disseminating information on hepatitis C, said that the blood test for hepatitis C is “excellent” and that cases like this are rare.

She speculated that there could be a small window of time in between infection and when hepatitis C would show up on a blood test, which could be why the infected kidney got through the screening.   

She said that hepatitis C is a blood-borne disease that has only had an official name since 1989. Before that, it was only known as non-A non-B hepatitis, and doctors believed it to be benign.

Now it is understood that hepatitis C causes scarring on the liver, and if that it persists long enough, it can cause cirrhosis.

Simon went on to say that hepatitis C is the most dangerous form of hepatitis because hepatitis A is self-remitting, meaning that it can’t become chronic, and hepatitis B only becomes chronic 10 percent of the time. Hepatitis C becomes chronic 70 percent of the time.

But hepatitis C is not always life threatening, and since its discovery in 1989, treatments have been improving. Just last week, a new drug was FDA-approved that treats chronic hepatitis C, and Simon said that she expects another drug to be approved shortly as well.

“This is the first time there has been a new treatment for hepatitis C in many, many years,” she said.

Simon said that hepatitis C was most commonly transmitted through blood transfusions, although the blood supply has been clean since 1992. Now the most common route of infection is by contaminated needles.

Hepatitis C is only very rarely a sexually transmitted disease, unlike hepatitis B, which is often spread sexually. Hepatitis C is not found in sexual fluids, so it can only be passed on through blood transfer.

Unlike hepatitis A and hepatitis B, there is no vaccine for hepatitis C.

According to the website for the Centers for Disease Control and Prevention, 3.2 million people in the United States are currently infected with hepatitis C.