Nearly 1 in 5 waiting for liver transplant won't get it – but that could change

A Georgia father was quickly referred to Piedmont Atlanta Hospital and put on the transplant list. But while he waited, his condition went downhill.

ATLANTA — In November 2017, Joseph Steadham's doctor told him that his liver was failing, and he needed a transplant.

"When I got that news, it was just gut-wrenching," said Steadham. "There really is nothing I can do."

The Georgia father was quickly referred to Piedmont Atlanta Hospital and put on the transplant list. But while he waited, his condition went downhill.

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"I could feel my body getting worse," he said. "My energy level was just slowly going down, it was hard to keep up throughout the day."

But his MELD score, which helps determine how long someone waits for an organ transplant, wasn't changing.

"Sometimes the meld score doesn’t really represent how sick someone is," said Dr. Raymond Rubin, the chief scientific officer at the Piedmont Transplant Institute. "So we thought, what a great opportunity to get him an organ sooner than his number would have come up otherwise."

Rubin was working on a study involving organs that have been exposed to hepatitis C (HCV).

In the clinical trial, a patient like Steadham, who did not have hepatitis C, accepted an organ from a donor that did have the virus.


After the transplant, doctors treated the newly infected patient for HCV, curing them within weeks.
Steadham, the first participant, received his liver transplant in July 2018. He had been on the waitlist for eight months.

"It was the option that I had at the time and I was really happy to do it," Steadham said.

According to Rubin, if this became common practice, it could create a larger potential organ pool, shortening the wait time for those who need new organs.

Nearly 1 in 5 patients who need a liver transplant die before one becomes available, according to Piedmont Atlanta Hospital. For patients listed for a kidney transplant, the average waiting time in Georgia is seven to nine years.

"In some parts of the country, 10 to 15 percent of potential organ donors are hepatitis C-positive," said Rubin. “Traditionally, many of these organs would go to waste."

The large number of infected organs is partly due to the nationwide opioid epidemic.

According to the CDC, most people get hepatitis C by sharing needles. New infections more than tripled between 2011 and 2016.

Rubin said a number of those who die by overdose had HCV, but were otherwise healthy.

"While it’s a terrible tragedy, we looked at this as a potential opportunity for expanding the donor pool for recipients that don’t have hepatitis C," he said.

Overall, the study expects to enroll 30 transplant recipients across the country. Piedmont Atlanta Hospital is one of six trial locations. The study's estimated completion date is January 2021.

When this report was published, 13 people had received kidney or liver transplants as part of the study. Five of the patients were at Piedmont Atlanta Hospital.

"So far, there haven’t been any patients where the virus has broken through the treatment," said Rubin.

Steadham said he was grateful for the opportunity.

"This is probably the healthiest I’ve been in my life," Steadham said. "I like to spend every moment with my family and just, being up and outside."