How safe accepting a liver w/ possible Hep B & Syphillis

Before my liver transplant I was asked by Mayo if I was willing to take a liver with Hep B. It was a top surgeon and he assured me they could "take care of it" with drugs if I got one. So I said sure. My actual liver did not have that. There was no mention of Syphillis , I would have remembered that for sure. Sounds scary to me but if it's Mayo suggesting it I would trust them. Same old story more folks who need new livers than livers so they have to use what they can. Best of luck.

I was offered a liver with Hepatitis B, I accepted because I was really sick and they assured me it could be fixed. So we made the 6hr drive to Dallas and got all the way to pre-op (outside the operating door and was told the liver was no good. They said the info on the liver was not complete and it had other issues. So at 1:30am we were told no go. We spent the rest of the night at a hotel and drove home. However a little over a week latter I had a new liver and that was 11 years ago.
Mike

@craigcraig I was told the same thing at NY Presbyterian. If the surgeons tell you they can work with the liver and your MELD score is such that you need to act, I would advise you to take it.

THANKS so much for all of the advice. I'll consider it!!!

I believe they tell all of us that and you don’t have to be put on a list to accept such a liver if I remember right. But I do believe you can’t refuse a healthy transplant and if you do then you are removed from the list. I could be wrong.
I myself got a liver too big for me. Nothing wrong with it otherwise but since I am a tall man at least for the transplant list, it surprisingly made it easier. They stuffed me like a turkey. My wife is a nurse and she still comments on the bulge from it. I’m happy to have received it.
I went through the calls to be on the way and get the call it’s a no go. Most of us probably get that phone call. It’s a confusing time for everyone the team and you because it’s not expected.
They do a lot of inspecting and testing of the liver before they will transplant it. They call you as soon as it’s a maybe to have you on your way. If they find something wrong they let you know as soon as they know. Probably another common phone call.
I don’t believe your transplant team would waste resources on a liver that is bound to fail. After the transplant you are watched like a hawk at the hospital for a few weeks then here required to live within 15 minutes of the Transplant Hospital for a Month.

According to the National Institutes of Health: While using an HCV-positive liver carries a high risk of transmitting the virus to the recipient, modern antiviral medications (DAAs) have a cure rate exceeding 95%. Often, treatment is initiated after the virus is detected in the recipient, resulting in high survival rates similar to recipients of negative grafts. Syphilis Management: Donor syphilis is not a contraindication for transplant. Recipients are treated with prophylactic antibiotics (like penicillin) to prevent infection, allowing for successful transplantation. Outcomes: Studies indicate that syphilis-positive liver grafts do not cause significantly higher morbidity, mortality, or poor prognosis compared to negative grafts. Risk vs. Benefit: For patients with life-threatening conditions, using these organs significantly reduces wait times on the transplant list and can be a life-saving option. Note: Informed consent is necessary, and close monitoring by a transplant team is required
Best wishes and good luck!

@smmattocks my transplanted liver which I received 4+ years ago at Mass Gen is a hep b positive liver. I knew this was a possibility before I was called for surgery and was assured that hep b is a treatable illness. This has been my experience- it has not seemed to be a problem for me. I take a medication entecavir every day which I will do for the rest of my life similar to tacrolimus, my only anti rejection med at this point.

The only issues for me have been that I consistently have elevated liver enzymes- just slightly- which my PCP and gastro doc consider to be a factor despite my entecavir.

Also, my liver team has been so shy about my concern about transmitting hep b to my male partner so I did my own research and understood that I’m not infectious if I take entecavir and my every 6 month blood work shows a negative viral load (it does).

I’ve not heard about syphilus as a potential infection to be dealt with within a transplant- I’d be careful and ask.

In my experience I think a hep b positive liver can be safe as this is a disease well managed these days.

Best care for you-
Kate