*Purpose: Recent data show that organs from donors who are HCV positive (+ve) can be safely transplanted into HCV negative recipients. We conducted a survey of lung transplant recipients and candidates who had consented to receive an HCV+ve organ. The purpose was to determine factors influencing the decision to accept HCV+ve organs and the psychosocial impacts in the post-transplant period.

*Methods: Adult lung transplant patients or candidates who had consented to receive an HCV+ve organ completed a survey consisting of 55 questions including multiple choice, a 5-point Likert scale, and free-text answers, with categories related to demographics, pre-transplant attitudes towards HCV+ve organs, decisions around acceptance, and post-transplant impacts of receiving HCV+ve organs.

*Results: A total of 67 HCV-negative lung transplant recipients or candidates who had consented to receive HCV+ve organs were enrolled in the study (median age 27-76 years; 61% male). 24/67 (36%) received lungs that were HCV+ve, 36 (54%) received HCV negative lungs, and 7(10%) were still on the waiting list at the time of survey. Prior to transplant 50/67 (75%) patients felt it was either completely safe or very safe to accept an HCV+ve organ. This was also consistent with both their family’s attitude and their primary physician’s attitude. Although 22/67 (33%) saw themselves as people who never or rarely took risks, they still made the decision to accept an HCV+ve organ. Common themes in the pre-transplant setting were desperation, perception of having ‘no choice’, and increasing severity of symptoms. In the subset of patients that were offered and accepted an HCV+ve organ (n=24), 33% were somewhat or very concerned about contracting HCV, and only 12.5% expressed having second thoughts about accepting the organ. Post-transplant, the majority (87.5%) never felt any anxiety about HCV. Most (83%) reported no impact from HCV on their overall well-being after transplantation. Generally, patients were not concerned about the risk of transmission to family members sufficiently enough to alter any of their behaviours after receiving the transplant. Perception of treatment tolerability and ease was highly favourable in most patients. 87.5% of patients said they would still have accepted an HCV+ve organ if they had to do it over again, and had similar advice for others. For those who consented to HCV+ve organs but received an HCV negative organ, 53% of patients were somewhat or very relieved, but most (89%) were likely or very likely to accept an HCV organ if needed in the future.

*Conclusions: Our survey provides unique insights into acceptance of HCV positive organs. Overall, patients found the experience to be very acceptable and positive. Use of these organs has minimal detrimental psychosocial impacts on lung transplant patients.

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