Exploring patient willingness to accept hepatitis C-infected kidneys for transplantation
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RESEARCH ARTICLE
Open Access
Exploring patient willingness to accept hepatitis C-infected kidneys for transplantation Gretchen C. Edwards1* , Maren E. Shipe1, Lindsay Smith2, Christianna Gamble2, David Shaffer3, Beatrice P. Concepcion4 and Rachel Forbes3
Abstract Background: As organs infected with Hepatitis C virus (HCV) provide an opportunity to expand the donor pool, the primary aim of this study is to explore patient willingness to accept a kidney from HCV-infected donors compared to other high-risk donors. Methods: An anonymous, electronic survey was sent to all active kidney transplant waitlist patients at a single large volume transplant center. Patients were asked to respond to three hypothetical organ offers from the following: 1) HCV-infected donor 2) Donor with active intravenous drug use and 3) Donor with longstanding diabetes and hypertension. Results: The survey was sent to 435 patients of which 125 responded (29% response rate). While 86 out of 125 patients (69%) were willing to accept an HCV-infected kidney, only a minority of respondents were willing to accept a kidney from other high-risk donors. In contrast to other studies, by multivariable logistic regression, age and race were not associated with willingness to accept an HCV-infected kidney. Conclusions: In this exploratory study, utilization of kidneys from HCV-infected donors to expand the donor pool appears to be an acceptable option to patients. Keywords: Hepatitis C, PHS-high risk, Expanded donor criteria, Deceased donor kidney transplant, Disparities
Background There is a critical shortage of donor organs for patients awaiting kidney transplantation. According to the Organ Procurement and Transplantation Network (OPTN), nearly 100,000 patients remain on the kidney transplant waiting list in the United States (U.S.) and yet only 10, 000 patients underwent deceased donor kidney transplantation in 2018 [1]. As the demand for organs continues to outpace supply and waiting times exceed up to * Correspondence: [email protected] 1 Department of General Surgery, Vanderbilt University Medical Center, Medical Center North, Suite CCC-4312, 1161 21st Avenue South, Nashville, TN 37232-2730, USA Full list of author information is available at the end of the article
5 years in many parts of the country, multiple approaches are now being considered to safely expand the donor pool [2]. These include donation after circulatory death, public health service (PHS) increased risk donors, older donors with comorbidities, and those previously exposed to or infected with hepatitis C (HCV). The ongoing opioid epidemic in the U.S. has resulted in a dramatic increase in the number of deaths due to overdose with intravenous drug use (IVDU), leading to a significant increase in donors classified as PHS increased risk and those infected with HCV [3]. With the advent of direct-acting antiviral agents (DAA) for the treatment of HCV, there has been great interest in the potential to increase the donor pool by offering waitlisted patients
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