Infecting a patient with hepatitis C to save his life

CRAINES NEW YORK | Robin D Schatz

Montefiore became the first New York health system to use livers with hep-C in transplants for uninfected patients who might otherwise die waiting for a match. Alvin Fisher was first in line

THE PROS AND CONS: Fisher discussed all aspects of the transplant decision with the Montefiore team. Photo: Buck Innis
Alvin Fisher was back at Montefiore Health System on March 23, hospitalized again for problems related to his failing liver. He expected to be discharged the next day, but early that morning a doctor delivered the news: After 14 months, the Bronx hospital had found the 21-year-old a new liver. A man in his early 30s had died in a fall, and a team from Montefiore was heading upstate to examine the organ.

Fisher contained his emotions. "I didn't get my hopes up too much, because they could say at the last minute it was too damaged for me to have," he said.

There was reason for Fisher to be circumspect. Until then he had been behind about 30 New Yorkers waiting for a liver, giving him just a 50-50 chance of surviving long enough to get a transplant. But five weeks earlier, doctors at Montefiore had made an offer that dramatically expanded his options: He could get a liver faster if he agreed to accept one with a potentially fatal disease. He said yes.

On March 24 Fisher became the first patient in New York City to be willingly infected with hepatitis C in order to obtain a liver that might otherwise have gone to waste. For Fisher that meant taking a leap of faith that the Montefiore doctors could cure him of hep C, a blood-borne virus that could itself cause cancer and liver failure. Continue reading
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