Is a damaged liver better than a dying one?

Replace a dying liver with a damaged one, and then cure the damaged one? That’s the latest approach physicians at the Intermountain Medical Center, Salt Lake City, UT, have taken in some of the sickest patients awaiting liver transplantation, giving them new hope in face of interminably long waiting lists for transplantation.

In 2016, 7,000 patients received a liver transplant. When one considers the 17,000 who are already on the liver transplant waiting list, adding a further 13,000 individuals to the list this year alone, 7,000 is a paltry sum. Consider also that roughly 1,500 people die annually while on the waiting list, and another 17,000 are removed for being too sick before their turn arrives.

“We’re excited about the possibilities this opens when it comes to providing life-saving treatment to some of the sickest patients waiting for a liver transplant,” said Richard Gilroy, MD, medical director of the Liver Transplantation Program at Intermountain Medical Center. “We are able to make what were felt damaged goods work and sometimes far better than we ever thought we could. This outcome means more people can be saved before they get too sick and allows them to move back to an active life sooner.”

The irony of this is that hepatitis C is now the most common indication for liver transplantation in the United States. But, many safeguards have been put into place to assure that patients receive a ‘safe’ liver infected with hepatitis C.

One such patient is Lorenzo Swank, who was diagnosed with primary sclerosing cholangitis (PSC) in 2010. He was added to the liver transplant waiting list in 2013, and for 3 years, had no problems. In May 2016, however, his health started to decline.

“Getting a transplant was the only solution that would allow me to overcome PSC,” said Swank, who has since been cured of the virus. “If I had not received the hepatitis C positive liver, I was weeks, if not days away from dying. Now my doctors are telling me I can get back to my regularly scheduled life.”

After transplantation, Swank underwent treatment for hepatitis C, and is now cured. Researchers at Intermountain Medical Center have used this transplant approach in one further patient, who is currently undergoing treatment for hepatitis C.

“Giving a curable disease to a patient is a lot better than letting them die from an incurable disease. We feel this new method will save many more lives by increasing the number of available donor livers to those on the liver transplant wait list,” concluded Dr. Gilroy.