Much appreciate seeing this topic here and the myths cleared up. We can indeed donate, and our livers can be used to help others. Advanced directives is a great way to make sure your wishes are carried out, and it most certainly takes the burden off family members in the event the person is unable to speak for themselves and decisions have to be made. If you do decide to do advanced directives now (which is a great idea for anyone who doesn't have a will yet or even if they do have one) make sure you get a copy to all of your physicians (GP, hep docs, any other specialists), take a copy to the hospital, give a copy to your loved one, and another good place to keep one is in your vehicle.
From: http://www.medpagetoday.com/MeetingCoverage/AASLD/11601
[....The need for donor livers far exceeds the supply, and extended-criteria donor selection has offered a partial solution to the organ shortage, Dr. Northrup noted. Use of HCV-positive grafts for HCV-positive patients offers an example of marginal-donor expansion.
Cirrhosis secondary to HCV infection has accounted for as many as half of all liver transplants performed in the U.S., and more than four million people are currently infected, Dr. Northrup continued.The issue of transplanting organs from HCV-positive donors has particular relevance in that population of liver transplant patients, he said, but the long-term consequences and outcomes had not been carefully studied.
So Dr. Northrup and colleagues analyzed the United Network for Organ Sharing/Organ Procurement and Transplantation Network dataset to identify all adult liver transplantations from January 1994 to February 2008 involving HCV-positive donors.
Patient and graft survival were assessed separately, accounting for donor and recipient HCV status.
Of 70,071 liver transplantations evaluated, 23,972 involved HCV-positive recipients, and 1,313 transplant procedures involved HCV-positive donors.
Three-fourths of HCV-positive donor organs went to HCV-positive recipients, and the remaining organs were given to HCV-negative patients in rare and extreme circumstances, said Dr. Northrup.
Transplants involving HCV-negative donors and recipients were associated with the best survival, an average of 11.7 years.
From that subgroup, mean survival decreased to 10.0 years for HCV-positive patients and HCV-negative donors; 8.28 years for HCV-positive donors and HCV-positive recipients; and 6.33 years for HCV-negative patients who received organs from HCV-positive donors.
HCV-negative patients who received livers from HCV-positive donors had the worst Model for End-Stage Liver Disease (MELD) score and more severe illness.
The researchers developed a survival model that adjusted for multiple variables known to affect survival after transplantation.
Using survival associated with transplants involving HCV-negative patients and donors as the reference, the investigators found that all other combinations increased the mortality hazard ratio by about 20%.
The mortality difference achieved statistical significance for the combination of HCV-positive recipients and HCV-negative donors (HR 1.21, 95% CI 1.17 to 1.25, P<0.0001), and HCV-positive recipients and HCV-positive donors (HR 1.23, 95% CI 1.08 to 1.40, P=0.002).
"After adjusting for known mortality risk factors in an HCV-positive recipient using multivariable proportional hazards survival models, we found that a potential recipient with HCV cirrhosis is not subjected to excess mortality if an HCV-positive liver allograft is used," Dr. Northrup said.]
Mike
Something I did not see mentioned here, but I only skimmed, is that HCV organs can be transplanted into HCV patients. In fact studies have been done on transplant recipients that have received HCV positive livers and they do just as well as those who get HCV neg livers. The number 1 reason for needing a lever transpant is hep C, so don't waste those HCV positive livers....be a donor!
They have very little time between Harvesting the Organs and Transplanting them. Is there anyway information such as HCV-SVR could be added? It seems to me this would help speed up the process and would also open the door to more recipients. Or is this information already on record? Glad the subject was brought up. I am still a Donor only because I never thought about it. I am glad I never did now.
Another option to simply telling our families our wishes about end of life scenarios is to fill out an Advance Health Care Directive. These simple forms vary from state to sate, but are readily available for free download (or nominal fee) from the internet. Here’s an example of California’s directive:
http://www.ilrg.com/forms/states/ca-medicaldirective.html
For other state forms, just enter Advance Health Care Directive + your state into a search engine.
This form will allow you to give family written instructions regarding your health care *only* in the event you can no longer speak for yourself. It might take a big burden off loved ones; think about it.
Bill