Immigration and Customs Enforcement raided a cell phone repair company in Texas on Wednesday. Buses left the site a few hours after the raid began, presumably with some of the 280 workers arrested for being in the country without proper documentation.
Immigration and Customs Enforcement arrested 280 employees at a technology repair company in Collin County, Texas, on charges of working in the United States illegally. It’s the largest worksite raid in the country in nearly 10 years, an Homeland Security Investigations official said.
The raid came after a Homeland Security investigation into CVE Technology Group in Allen, Texas, which refurbishes and repairs cellphones and other consumer electronics.
In a statement, Katrina Berger, Special Agent in Charge in HSI Dallas, said her office received tips that the company may have knowingly hired undocumented immigrants and that “many of the individuals employed at CVE were using fraudulent identification documents.”
Hiring irregularities found during an HSI audit of CVE’s I-9 forms confirmed those tips.
The largest workplace raid to ever take place in the U.S. was in Postville, Iowa, in May of 2008, where almost 400 undocumented workers were arrested.
What’s next for the arrested employees
The workers arrested on Wednesday will first be interviewed by ICE, who will make note of “humanitarian situations” such as medical needs, or if a worker is the sole caretaker of another person such as a child.
Based on those interviews, ICE will decide who remains in immediate custody and who can be considered for temporary humanitarian release.
Either way, ICE said in a statement that “in all cases, all illegal aliens encountered will be fingerprinted and processed for removal from the United States.”
Families wait outside during the raid
Late Wednesday morning, workers inside the repair plant began texting and calling family members, who arrived outside the building and waited for information. One of them got a text from his wife, who asked him to call an attorney.
Maria Soria waited outside the repair plant, in tears. Her mother, Socorro Lechuga, 46, is an employee there and was eventually released by ICE agents.
Soria, 24, said her mother, already had a petition for legalization in place before the raid. Lechuga is originally from Guerrero, Mexico.
Socorro Lechuga (right) who’s worked for CVE Technology Group for around six years, was released by ICE agents conducting a raid at the company. Maria Soria (left) came from a nearby town to be with her mother.
Stella M. Chavez/KERA
Stella M. Chavez/KERA
Around 10 a.m. Thursday, Soria received voicemail from her mother saying that ICE agents had arrived at the company and that she didn’t “know what’s going to happen.”
“I was worried at first, because you hear ‘ICE’ and everything goes downhill,” Soria said. “I got myself together,” and left work at a health care insurance company in to drive to Allen.
She called her mother’s lawyer, who told her not to worry because, he said, “they’ll either release her or set a bond to to be released within 48 hours” and that “they can’t do anything to her, pretty much, because she does have a petition in place.”
“So that gave me a peace of mind, that at least I know my mom will be OK,” Soria said. “As far anyone else here, I really don’t know their status or their situation, so that’s a whole different story.”
During the raid
Mathew Varughese, who says he repairs cellphones at CVE, described the scene inside the company. He said around 10 a.m. Wednesday, agents arrived, and some employees began running. Agents instructed workers to group together by legal status.
Employees who work at the company with legal immigration papers were given green wrist bands to wear.
By then, the reactions from employees were mixed — “Standing, no talking. Ladies crying,” he said.
He said he estimates that about 60 percent of CVE Technology employees are women.
One woman was in the building applying for a job at the same time that ICE agents arrived. She says there were hundreds of people inside.
— Anthony Cave (@Anthony_Cave) April 3, 2019
Buses, at least one of which said LaSalle Corrections Transport, left CVE a few hours after the raid began, presumably with workers inside. Some demonstrators yelled toward one of the buses, “We see you, we love you.”
Third-largest employer in Allen
According to the Allen Economic Development Corporation website, CVE has 2,100 employees, making it the third-largest employer in city.
CVE already had an office in Plano when it moved its headquarters from New Jersey to Allen in 2014. The company was founded by Howard Cho in 1986 and is now headed by his son Edward Cho.
In 2014, Samsung accounted for 75 percent of the company’s business, but CVE planned to reduce that significantly as they expanded, according to North Jersey Media Group.
The company was honored in 2017 by the U.S. Dept. of Commerce’s Minority Business Development Agency with a national award.
KERA has reached out to CVE Technology for comment.
President Trump told reporters on Wednesday that he was “not inclined” to adhere to a demand from a congressional Democrat for the IRS to hand over copies of the president’s tax returns.
Democrats have long called for President Trump to release his tax returns, and now a key congressman has put in a formal request with the IRS.
Massachusetts Democrat Richard Neal, chairman of the House Ways and Means Committee, is requesting six years of Trump’s personal tax returns and the returns for some of his businesses for the years 2013-2018. Neal argues that Congress, his committee in particular, needs to conduct oversight of the IRS, including its policy of auditing the tax returns of sitting presidents.
“We have completed the necessary groundwork for a request of this magnitude and I am certain we are within our legitimate legislative, legal, and oversight rights,” he said in a statement about the request.
Neal said the action was about “policy, not politics.”
“My actions reflect an abiding reverence for our democracy and our institutions, and are in no way based on emotion of the moment or partisanship,” he said.
In his letter IRS Commissioner Charles Rettig, Neal asked for the information by April 10.
Trump has been unique compared to recent presidents in his refusal to release his personal tax returns.
Trump said on Wednesday he was “not inclined” to adhere to the demand.
Poor diet is the leading risk factor for deaths from lifestyle-related diseases in the majority of the world, according to new research.
John D. Buffington/Getty Images
John D. Buffington/Getty Images
About 11 million deaths a year are linked to poor diets around the globe.
And what’s driving this? As a planet we don’t eat enough healthy foods including whole grains, nuts, seeds, fruits and vegetables. At the same time, we consume too many sugary drinks, too much salt and too much processed meat.
As part of a new study study published in The Lancet, researchers analyzed the diets of people in 195 countries using survey data, as well as sales data and household expenditure data. Then, they estimated the impact of poor diets on the risk of death from diseases including heart disease, certain cancers and diabetes. (They also calculated the number of deaths related to other risk factors, such as smoking and drug use, at the global level.)
“This study shows that poor diet is the leading risk factor for deaths in the majority of the countries of the world,” says study author Ashkan Afshin of the Institute for Health Metrics and Evaluation at the University of Washington. Unhealthy diets are “a larger determinant of ill health than either tobacco or high blood pressure,” he says.
So, which countries do best when it comes to diet? Israel, France, Spain and Japan were among the countries with the lowest rates of diet-related disease. The U.S ranked 43rd, and China ranked 140th. It should be noted that there were data gaps for intake of key foods in some countries, so some estimates could be off.
“Generally, the countries that have a diet close to the Mediterranean diet, which has higher intake of fruits, vegetables, nuts and healthy oils [including olive oil and omega-3 fatty acids from fish] are the countries where we see the lowest number of [diet-related] deaths,” Afshin says. And as we’ve reported, the Mediterranean pattern of eating is linked to a reduced risk of heart attacks and memory decline.
I asked Afshin which ranking surprised him and why. “Mexico is interesting,” Afshin told me. The country ranked 11th on the list. On the one hand, people in Mexico consume a lot of whole grain corn tortillas, he says — and whole grains are beneficial. But on the other hand, “Mexico has one of the highest levels of consumption of sugar-sweetened beverages.” It’s hard to say how the benefits of whole grains may influence the risks of too much sugar, but Afshin says it underscores a problem seen in many countries: the overall pattern of eating could be improved.
Of course, there are obstacles to eating well, including access and affordability. As the Trump administration and U.S. lawmakers debate whether able-bodied people who don’t work should be entitled to public food assistance, it’s clear that many people around the globe struggle to afford healthy foods.
And at a time when 800 million people around the globe don’t get enough to eat, and 1.9 billion people weigh too much, it’s important to remember that hunger and obesity are both forms of malnutrition. And the costs are staggering. Consider a recent report from the Center for Strategic and International Studies, which notes: “Worldwide, malnutrition costs $3.5 trillion annually, with overweight- and obesity-related noncommunicable diseases, such as cardiovascular disease and type 2 diabetes, adding $2 trillion.”
Globally, these findings may serve as a reminder that when it comes to ending hunger and improving health, people don’t just need food. They need nourishment. If you fill up on a diet of packaged snacks made from refined-carbohydrates and sugary sodas, you may get the calories you need. But those calories will put you on a path toward disease.
So, what would happen if everyone around the globe began to eat a healthy diet, filling three-fourths of their plates with fruits, vegetables and whole grains? We’d run out. Yep, that’s right. A recent study published in the journal PLOS One by researchers at the University of Guelph found that there would not be enough fruit and vegetables to go around.
“We simply can’t all adopt a healthy diet under the current global agriculture system,” says study co-author Evan Fraser, director of the Arrell Food Institute at the University of Guelph. Fraser says we produce too much fat, too much sugar and too many starchy products. So, food companies and farmers play a role, too. “At a global level, we have a mismatch between what we should be eating, and what we’re producing,” Fraser told me.
Perhaps that’s why the authors of the new Lancet study say their findings point to the need for coordinated, global efforts. Improving diets won’t be easy: A range of initiatives may be needed, including nutrition education and increased access to healthy foods, as well as rethinking agricultural production.
If you like this article, check out our deeper dive: NPR’s Life Kit podcast on six food rules to help you eat your way to a healthier life. Follow NPR’s Allison Aubrey at @AubreyNPRFood.
The sun sets over Lake George near Uganda’s Queen Elizabeth National Park in western Uganda, in this 2000 photo.
BRENNAN LINSLEY/ASSOCIATED PRESS
BRENNAN LINSLEY/ASSOCIATED PRESS
An American woman has reportedly been kidnapped while on a game drive in a Uganda national park, and four gunmen are holding her for $500,000 ransom. Ugandan police are in pursuit, officials say.
News of the abduction comes one day after U.S. Secretary of State Mike Pompeo told families of Americans held overseas that the U.S. won’t pay ransoms because that only encourages terrorists to seize more Americans.
The 35-year-old woman and a Ugandan tour guide were abducted from their vehicle at gunpoint Tuesday evening while driving through Queen Elizabeth National Park in southwestern Uganda, according to the Uganda Police Force.
The Uganda Media Centre said that after the kidnapping, four tourists were left “abandoned and unharmed,” and were rescued after they contacted national park officials. The park is located near the border with Congo.
Abductions of foreigners are not common in the region. Ugandan police say this is “the first incident of this kind” in the national park.
The State Department told NPR it is “aware of reports of a U.S. citizen kidnapped in Uganda. Local security forces are responding to the incident.” American officials have not confirmed the woman’s identity.
The U.S. Embassy in Uganda suggested that visitors “exercise caution when traveling to this area.”
At an event in Washington on Tuesday for the families of Americans held captive abroad, Pompeo said some people have suggested that the U.S. should return to the practice of paying ransom in exchange for abductee’s freedom.
“I understand this plea from the bottom of my heart; indeed, I am confident that if I stood in your shoes, I too would be willing to do anything,” Pompeo said. “I can understand that the suffering is unspeakable.”
But paying ransoms creates unacceptable risk, he said. “Please remember that any payment to a terrorist or a terrorist regime gives money so that they can seize more of our people,” Pompeo said. “Even a small payment to a group in, say, Africa can facilitate the killing or seizure of tens or even hundreds of others, including Americans or foreign nationals in that region.”
“We also know for a fact that some terror groups don’t seize Americans because we won’t pay,” Pompeo added. “It’s a trend I want to continue.”
At a Senate hearing March 27, Daniel Elwell, acting director of the Federal Aviation Administration, said airline pilots had enough training to handle Boeing’s flight control software.
Investigators are still piecing together what happened in the deadly crashes of a Lion Air flight in October and an Ethiopian Airlines flight last month, but this much is known: In both cases, the Boeing 737 Max planes crashed minutes after takeoff and after pilots appeared to struggle to control their planes.
They did not seem to know how to handle a system, called MCAS, that was forcing their planes into a nosedive.
At a hearing last week, Sen. Ted Cruz, R-Texas., chairman of the aviation subcommittee of the Senate Commerce Committee, pressed for answers from Daniel Elwell, the acting chief of the Federal Aviation Administration.
“There’s nothing in the pilot training about the MCAS system adjusting the nose of the plane downward and how to compensate for that in the event of a malfunctioning sensor,” Cruz said. “Is that accurate, that the training does not include that?”
“Senator, I would actually say that it is accounted for in the training,” Elwell replied. Elwell went on to say that the real problem the 737 Max pilots faced was something called runaway pitch trim.
That problem concerns the pitch, or angle of the plane’s nose in the air. Every aircraft has systems for adjusting the pitch. When a plane is cruising it’s usually controlled by autopilot.
But if the pitch trim system is out of control, pilots are trained to take over and fly the plane manually. Elwell emphasized that all pilots should know how to do that.
“You’re not fumbling through books, it’s a time-critical procedure, and you go to that,” he told lawmakers.
The 737 Max is different, though. Boeing installed a software program called MCAS, short for Maneuvering Characteristics Augmentation System. It’s meant to help pilots prevent a stall by pushing the nose of the plane down if it senses the plane is flying at too steep of an angle.
Pilots can override MCAS. But a lot of pilots say they didn’t know the software existed until after the Lion Air crash. They say the manual did not explain it or provide explicit instructions on how to disable it.
Capt. Jason Goldberg flies for American Airlines and is a spokesman for its union, the Allied Pilots Association. He disagrees that pilots got enough training to handle MCAS.
“I hate to be in a position to contradict Acting Director Elwell, but in this case the statement is not correct,” Goldberg says.
Goldberg says it’s true that pilots train to overcome pitch trim problems, so they can get the plane’s nose flying at the correct angle if the system goes haywire.
But an MCAS malfunction on a Boeing 737 Max creates a host of other problems and they’re all distracting.
“You would have the stick shaker, which [activates] a rather violent aggressive shaking of the control column,” Goldberg says. “You would have the appearance of unreliable airspeed. You would have a number of warnings that don’t immediately or intuitively give the impression of a pitch trim problem.”
MCAS seems to have baffled pilots in the two crashes. The Lion Air pilots reportedly flipped through a manual looking for answers before their plane crashed, killing all on board.
A spokesperson for the Air Line Pilots Association of Ethiopia told NPR there was nothing in the training to prepare pilots for the situation they faced. Ethiopian Airlines says it has a simulator for the 737 Max 8, but the pilots association said there was no setting for an MCAS scenario.
Boeing has not confirmed that claim.
Even among pilots of major U.S. airlines, Elwell has triggered a stark difference of opinion.
“We have been trained on how to handle the mishap that occurred in at least the Lion Air jet that we know about,” says James Belton, a United Airlines pilot and spokesman for the Air Line Pilots Association.
Belton says the manual described how a 737 Max will respond in the kind of scenario that would trigger MCAS, even if it did not name the software outright. Further, he says the FAA issued a directive after the Lion Air crash that provided clearer instructions. Belton says U.S. airlines have flown the 737 Max for more than 100,000 hours, including some 23,000 hours at United, without a problem.
“I can’t really comment as to the training that they get overseas, but I know here in America … we have not seen one data point saying that we had a performance or a maintenance issue with it,” he says.
Belton says that clean record is testament to rigorous U.S. standards.
In most cases in the U.S., both the captain and the first officer — the copilot — need at least 1,500 hours of flight experience. Overseas, first officers might have as little as 250 hours.
On the Ethiopian Airlines flight that crashed, the captain had 8,100 hours of flight time but the first officer had 350 hours, according to the airline.
Elwell’s claim that pilots were prepared for the MCAS has raised eyebrows among some training experts.
“I find it surprising that a system that affects the pitch control of an aircraft of any description is not brought to the attention of the people that are going to be flying it,” says Dai Whittingham, chief executive of the United Kingdom Flight Safety Committee. The group promotes commercial air safety and counts British Airways, Virgin Atlantic and Ryanair among its members.
Whittingham says pointing to the pilots’ training as a possible reason for the two crashes is “deflecting responsibility from where it properly lies” — with Boeing and the FAA.
He says he believes U.S. pilots were just as vulnerable to an MCAS malfunction as their overseas counterparts. “I think it would have been possible for an American pilot to have crashed the 737 Max if they had not been able to diagnose the problem,” Whittingham says.
Goldberg at American Airlines says it’s not training alone that accounts for his safe experience flying the Max. He says his airline paid extra for additional safety equipment that helped pilots keep a closer eye on the information feeding into the MCAS system.
Boeing says those safety features will be standard on every 737 Max, and the company will provide extra pilot training. The company is also adjusting the MCAS software to be easier to override.
On Wednesday, Boeing announced that CEO Dennis Muilenburg joined the company’s test pilots on a 737 Max 7 flight to show how the updated MCAS software works. The manufacturer says it will run more tests and demonstration flights as it develops its software.
“Safety is our first priority, and we will take a thorough and disciplined approach to the development and testing of the update to ensure we take the time to get it right,” Boeing said in a statement.
Both Boeing and the FAA say the fix needs more time before the planes can fly again. For now, the 737 Max fleet continues to be grounded.
Simon Russell Beale, Ben Miles and Adam Godley portray multiple characters in The Lehman Trilogy, about the rise and fall of Lehman Brothers.
The Lehman Trilogy, which opened at the Park Avenue Armory in New York City on March 27, has been produced in France, Germany and Italy. An Italian, Stefano Massini, wrote it; the Englishman Sam Mendes directed it.
And yet the story is quintessentially American. Three Orthodox Jews from Bavaria arrive in New York in the mid-19th century; eventually two of them settle in the very neighborhood where the play is being staged. And over the next decades, they build one of the most influential economic behemoths in the world: Lehman Brothers.
That financial powerhouse emerged from modest beginnings. The eldest Lehman brother, Henry — played with an earnest, commanding presence by Simon Russell Beale — arrived in New York in 1844 and headed south, to Montgomery, Ala., where he opens a general store. His observance of the Jewish Sabbath turns out to be an asset: His shop, which then sells cloth and garments, is closed on Friday evening and Saturday, but open on Sunday, when most establishments are shuttered but customers are pouring into town to attend church.
Henry’s brothers, Emanuel (played by Ben Miles) and Mayer (Adam Godley), join him in Alabama, and they seize upon new opportunities to grow their business. They start selling products farmers need to grow cotton, like rakes and seed. Then they sell the crop itself. When Emanuel takes a trip to New York, he is smitten with the city, a place he describes as “completely shameless and completely sublime.” It will become the extended Lehman family’s home. From there they will trade coffee and oil, finance railroads and airlines, and wade into film production (they were behind hits like King Kong and Gone with the Wind).
In a talk at the Armory, director Sam Mendes described how the original staging of The Lehman Trilogy featured a dozen actors. He eventually whittled the cast to the three men, who collectively play some 70 characters, and these transformations occur with no costume changes. Modulating their bodies and voices, they become women, children and decrepit old men. Beale’s turn as a dyspeptic rabbi schooling the independent-minded 9-year-old Herbert Lehman — who would grow up to be a legendary New York senator and governor — is one of the comedic highlights of the play. And Adam Godley’s literal dance to the death as Bobbie Lehman, the last member of the family to helm the firm, is riveting. At the production I attended, audience members spontaneously broke into applause as he sank into the floor.
The play does not delve into the collapse of Lehman Brothers in 2008, which sent off economic gyrations around the world. The insinuation is that the bank’s shift from investing in actual products and industries to focusing on pure financial machinations led to its demise. It is perhaps a testament to the power of the storytelling that even though the implosion of the firm happens in a rushed 20 minutes, it doesn’t detract from the play’s emotional heft. The writing is lyrical: The newly-arrived Henry describes the bustle that greets him when he gets off the boat as “the magical music box called America.” When Bobbie Lehman creates a trading desk, one of the older Jewish investors visits the room where men yell out numbers and stocks, and ruefully remarks on how far the firm has evolved away from “velvet and cuff links.”
What stands out most in this production are the troika of actors. They are almost never absent from the stage during the nearly 3 1/2 hour production. They were collectively nominated for the Olivier Award for Best Actor, the British equivalent of the Tonys. That seems fitting, because working together — dressed in stark costumes, with minimal props — they manage to make worlds come alive.
Alexandra Starr, a frequent NPR contributor, is a Spencer fellow at Columbia University.
A promotional sale on Nutella was more successful than planned: Customers came to blows trying to get jars of the sweet spread after a grocery chain cut prices by 70 percent.
Global demand for hazelnuts is on the rise, but the industry has a problem. More than 70% of the world’s hazelnuts come from just one place: Turkey. And that leaves producers and Nutella lovers everywhere vulnerable.
But lucky for them one scientist in New Jersey has spent the last 23 years on a global quest to reinvent the hazelnut. And now his dream may finally be coming to fruition.
Today on The Indicator: how one man’s lifelong obsession could end up revolutionizing an entire industry.
Music: “Morning Start”
Whether he’s investigating such contentious celebs as André the Giant and Andy Kaufman or delving into the mythology of Tetris, Box Brown has a knack for using comics to illuminate tricky subjects.
Brown’s pared-down drawings provide the perfect support for stories freighted with layers of misinformation and irony. Now he’s turned his attention to one of the touchiest topics in today’s news: marijuana. Cannabis: The Illegalization of Weed in America digs into the drug’s history and the century-long, globe-spanning crusade against it. Brown enlivens his story with a host of quirky details, such as the reason old ads and articles sometimes call marijuana “marihuana.” (Prohibitionists wanted to tap into anti-immigrant sentiment by emphasizing the drug’s roots in Mexico.)
Brown spoke with NPR about his motivation for creating the book, the link between past and present drug policy and the surprising historical significance of his unusual name.
How did you get interested in this topic?
I have a long history with cannabis. I was arrested for possession when I was 16 [in the mid-’90s]. It was a very informative experience for me — I was able to see the ins and outs of the legal system at a young age. If a kid got busted with beer at a party, they would get some very minor, non-court-related arrest — or not get any kind of punishment. If you had marijuana, that meant handcuffs, detention, court, then probation. You’re tied up in the legal system.
How was the history of marijuana in the United States bound up with racism and anti-immigrant sentiment?
The first laws in the U.S. prohibiting cannabis use were passed anywhere the immigrant Mexican population butted up with the United States. El Paso, Texas, had one of the first local ordinances prohibiting cannabis, and it was with the purpose of deporting Mexicans. In the 1930s, jazz musicians were targeted as likely marijuana users.
A page from Cannabis, by Box Brown.
Was that something that surprised you?
It was surprising and it wasn’t surprising. Today people of color are arrested at much greater levels for cannabis possession, even though use levels are equal among races. Finding out it was always about race was just like, “Oh, yeah. Of course.”
The most interesting aspect of the whole story, to me, is what we did to India. India has a culture with cannabis that goes back as long as we know. It’s in their holy books. In the 1930s, the United States forced every country in the United Nations to make cannabis illegal. Now India has to bend to the will of the U.S.
Your book’s bête noire is Harry J. Anslinger, who was appointed as the first commissioner of the Federal Bureau of Narcotics in 1930. What was Anslinger’s influence on marijuana law?
His efforts to build up cannabis prohibition can’t really be overstated. He fought tooth and nail, using all of the levers of power at his disposal, to change public opinion and influence those in high places. He had access to William Randolph Hearst, the most powerful media mogul at the time, and he went on his own little propaganda tour around the country to make sure every state signed on to prohibition.
Many, many people who came after him followed his playbook. We’re still under his thumb.
Are there ways the conversation around cannabis is still influenced by people like Anslinger?
Tons of “reefer madness” stuff comes up every day. “Cannabis makes people psychotic” is something that still comes up all the time, along with the gateway drug theory, which was made up wholeheartedly by Anslinger.
At the end of the book, you become particularly explicit about your pro-cannabis stance. Why end on that note?
I wanted to make it clear that marijuana has been completely maligned. We should consider it like aloe, coffee, or any other plant we use to make our lives better. Even when it’s legalized, we still punish the plant with exorbitant taxes. This unfair maligning of a plant still goes on today.
Before we say goodbye, I’ve got to know — how did you come to be named Box?
It was a nickname I got in college — it really didn’t make any sense. But I found out later that there was a real person known as Box Brown. His name was Henry Brown, and he was a slave. He mailed himself to the North in a box and survived the trip.
That’s an amazing story.
Yeah, he mailed himself to freedom.
Etelka Lehoczky has written about books for The Atlantic, the Los Angeles Review of Books, The New York Times and other publications. She tweets at @EtelkaL.
The presence of the hepatitis C virus in donated hearts and organs for transplantation wasn’t an impediment for a successful result for recipients.
Kateryna Kon/Getty Images
Kateryna Kon/Getty Images
Donated organs from people who were infected with the hepatitis C virus can be safely transplanted, according to the latest in a line of studies that are building a case for using these organs.
Typically, these organs have been discarded because of concerns about spreading the viral infection. But a study of heart and lung transplants published Wednesday by the New England Journal of Medicine finds that new antiviral drugs are so effective that the recipients can be protected from infection.
And, as another sad result of the opioid epidemic, organs for donation increasingly carry the hepatitis C virus. People who use injected drugs and share needles are at high risk of hepatitis C infection.
These organs represent a resource the transplant surgeons at Brigham and Women’s Hospital in Boston didn’t want to go to waste. They decided to run a study to see whether the organs could be safely transplanted.
Mike Caldwell volunteered. Seven years ago, he was diagnosed with chronic obstructive pulmonary disease. He had worked for many years rehabbing concrete floors and hadn’t worn a face mask as cement dust and chemicals swirled around him. He also smoked.
The Kingston, Mass., resident says an oxygen mask kept him alive, though eventually he couldn’t even climb the stairs. He got on the list for a lung transplant.
“I was waiting for the lung and waiting and waiting,” he says. “I needed a double lung transplant.”
Three years went by. Then in the spring of 2017, a researcher at Brigham and Women’s asked him if he would consider enrolling in a clinical trial. He might end up getting lungs from a donor who had been infected with hepatitis C. If so, he would also get a course of antiviral drugs that can block transmission of the virus.
“I had to think about it,” he says. “It wasn’t a decision overnight.”
But in the end, the risks seemed manageable, certainly compared with the possibility of dying while still waiting for a suitable donor.
“I really had nothing to lose at that point in time,” he says.
Just a few weeks after he agreed to participate, he got lungs from a donor who had been infected with hepatitis C.
Now, the 59-year-old Caldwell says he is doing fine. At first he started to panic when he couldn’t feel the familiar oxygen mask on his face. Then he realized he didn’t need it anymore.
Before the transplant, “I couldn’t even think of doing something without running out of air,” he says.
Brigham and Women’s Dr. Ann Woolley, who organized the study, says participants didn’t get moved up on the transplant list, but by enrolling in the study they had access to a larger number of organs. Woolley says given the sad reality of the opioid epidemic, these organs have become common in the past few years.
“Over a third of all of our heart and lung transplants that we’ve done at our center have been from donors who had hepatitis C,” she says.
Caldwell is among 44 patients in the study who had heart or lung transplants from infected donors.
Woolley says the challenge hasn’t simply been medical. More than two-thirds of the donors with hepatitis C in her study were recent drug users, including people who died of overdoses. Doctors and patients raised concerns about the quality of their organs.
“I think that is a stigma that very much is widespread,” she says. “Fortunately that pendulum is beginning to swing.”
She says the organs accepted for transplant from drug users weren’t lower quality. They met the same high standards as any donation. And the outcomes she now reports are encouraging. “We’ve had a 100 percent success rate, both in terms of the hepatitis C clearance as well as how well the patient has done after transplant,” she says.
This isn’t a definitive study, because it involved a small number of patients and the initial follow-up period was just six months.
“The early results are very encouraging, but there is still a lot to learn,” writes Dr. Emily Blumberg in an editorial accompanying the study. Blumberg, at the University of Pennsylvania, says she would like to see studies with longer follow-up periods. Once concern is that these transplant recipients could have a higher risk of heart disease in later years.
Still, more than 12,000 people on organ transplant lists die while waiting for a suitable organ, Blumberg wrote, so it’s time to consider expanding the use of these transplants, at least under controlled conditions.
Evidence is growing for the use of these organs. There have been similar small studies showing success with kidney and liver transplants. Recently, the director of the transplant center at NYU Langone Health, Dr. Robert Montgomery, needed a new heart himself. As The Wall Street Journal reported, he accepted one from a drug user who had hepatitis C and had died from an overdose.
A study last year concluded that heart transplant recipients were better off accepting an infected organ, compared with holding out on the waiting list for an organ that is not from an “increased risk donor.”
A single donor can potentially give as many as eight or nine organs, says Adnan Sherif, a kidney transplant doctor at Queen Elizabeth Hospital in Birmingham, England. So expanding the pool of available donors to include these organs can potentially help many people.
In addition to hepatitis C, some of these organs carry the risk of transmitting hepatitis B or HIV, Sharif says, but those conditions are manageable as well. And the new drugs to block or cure hepatitis C infections make a huge difference.
“I don’t think there’s many people who doubt these drugs are effective,” he says. “We could increase the pool of these organs. I think the real question really is with regards to the financial reimbursements.”
He is encouraged to see that the transplant team in Boston was able to block transmission of hepatitis C with just four weeks of treatment with these expensive drugs. That’s much less time than it takes to treat someone who is being cured of a hepatitis C infection, and it can save potentially tens of thousands of dollars.
You can contact NPR science correspondent Richard Harris at firstname.lastname@example.org.