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• W2920797310 abstract "Introduction: Direct-acting antivirals have changed the landscape of hepatitis C virus (HCV) care. While HCV + organ transplantation is increasing, little is known about providers' attitudes towards this topic. Methods: Willing transplant and non-transplant nephrologists, transplant surgeons, and mid-level providers completed an online survey from April-May 2018. The survey asked about HCV knowledge and willingness to transplant HCV +, NAT (nucleic acid testing) + kidneys into negative recipients. Descriptive analyses including mean and median for continuous variables and frequencies for categorical variables were calculated. Results: 700 surveys were emailed and 99 providers (62 transplant nephrologists, 28 non-transplant nephrologists, 7 transplant surgeons, and 2 mid-level providers) completed the survey (participation rate 14.1%, Table 1). 100% of providers knew that HCV was curable, with 60% believing that it had no effect on transplant success and 32% thinking it reduced transplant success. Providers were significantly more likely to offer an HCV + organ to HCV + patients compared to HCV - patients in all queried circumstances (p < 0.005 in all cases, Figure 1), especially with increasing impact on patient quality of life. While only 39% of providers would offer an HCV + organ for transplant to a patient without HCV if it reduced the waitlist time by 1 year, 92% would offer an HCV + organ if it reduced the waitlist time by 4 years. However, only 47% thought the use of HCV + kidneys should be for routine care while 38% believed it should be reserved for research purposes only. There were no significant differences between transplant and non-transplant nephrologists in attitudes towards HCV + / NAT + organ transplantation. Providers believed that donor organs from those who were obese, > 50 years old, or had died from a cardiac arrest were significantly more likely to reduce the likelihood of a successful transplant 1-year post-transplant when compared with an HCV + organ (p < 0.005 in all cases, Figure 2). 86% of providers were concerned about HCV curability post-transplant as a major concern.944_A Figure 1. Demographic and practice data amongst all survey participants.944_B Figure 2. Provider attitudes towards offering HCV+/NAT+ donor organs to both HCV+ (donor+/recipient+, D+/R+, blue bars) patients and HCV- (donor+/recipient-, D+/R-, orange bars) patients. The clinical scenarios above the bars were asked of providers to determine if they would offer an HCV+/NAT+ organ. HCV: hepatitis C virus; GFR: glomerular filtration rate; QOL: quality of life; DM: diabetes mellitus; CAD: coronary artery disease; NA: not applicable.Conclusion: Although 92% of providers were willing to offer an HCV + / NAT + kidney for transplant as patient waitlist time increases, less than half of providers believed in offering HCV + transplantation for routine care rather than for research. Further provider education is needed regarding the efficacy and safety of HCV + /NAT + kidney transplantation.944_C Figure 3. Provider attitudes towards whether organ donor sources affect the likelihood of a successful transplant 1-year post-transplant. There was no difference between IVDU and HCV+/NAT+ organ, and providers believed that an organ from a patient less than 50 years old who died accidentally was significantly less likely to reduce the success of transplant compared to an HCV+/NAT+ organ. HCV: hepatitis C virus; IVDU: intravenous drug user." @default.
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• W2920797310 date "2018-10-01" @default.
• W2920797310 modified "2023-09-27" @default.
• W2920797310 title "Provider Attitudes Towards the Use of Hepatitis C Virus Positive Organs in Kidney Transplantation" @default.
• W2920797310 doi "https://doi.org/10.14309/00000434-201810001-00944" @default.
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