Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Background: New HCV drugs could reduce the risks of donor-derived HCV infection. However, it is unknown if HCV-negative (HCV-) ESRD patients would accept an HCV+ kidney.
Methods: We first performed semi-structured interviews with 17 HCV- patients to assess attitudes about HCV+ organs. Next, in a conjoint study, 185 HCV- patients seeking transplant at two centers received concise education about HCV and the possibility of reducing waiting time by accepting an HCV+ kidney. Each participant made 12 decisions about whether to accept a hypothetical offer of a HCV+ transplant in which we varied expected waiting time for a HCV- offer (2 vs 5 yrs), kidney quality (60 year old donor with hypertension vs 20 yr donor) and probability of HCV cure (75%, 90% vs 95%). Participants also completed the “Trust in Physician” scale.
Results: Most interviewees had little knowledge of HCV; the most common theme was concern about viral complications. In conjoint scenarios, 29% of respondents would accept an HCV+ kidney under all scenarios, 53% would accept an HCV+ kidney only under some scenarios, and 18% refused all 12 HCV+ kidneys. For the binary outcome of refusing all HCV+ organs, black patients were more than twice as likely to refuse all offers (26% vs 12% for non-black patients, p=0.01). However, in a multivariable analysis of all 12 decisions, race and physician trust were not associated with overall decision-making; instead, participants who were older, male and prior transplant recipients were most willing to accept an HCV+ kidney. Willingness to accept an HCV+ kidney was strongly affected by cure rate and donor quality.
|HCV cure 95% (vs 75%)||2.45||1.95, 3.09||<0.01|
|HCV cure 90% (vs 75%)||1.81||1.50, 2.19||<0.01|
|20 year old donor (vs 60 yr)||2.30||1.87, 2.82||<0.01|
|Wait 5 yr for HCV- kidney (vs 2 yr)||1.43||1.24, 1.66||<0.01|
|Age >60 yrs (vs <45)||2.74||1.34, 5.61||<0.01|
|Age 46 – 60 yrs (vs <45)||1.22||0.66, 2.26||0.52|
|Prior transplant||2.88||1.13, 7.32||0.03|
Summary: Most HCV- patients would consider an HCV+ kidney transplant under certain circumstances. These findings should motivate wider usage of HCV+ kidneys.
CITATION INFORMATION: Reese P, Goldberg D, Mussell A, McCauley M, Sawinski D, Molina N, Tomlin R, Doshi S, Abt P, Blumberg E, Thiessen C, Kulkarni S, Esnaola G. Willingness of End-Stage Renal Disease Patients (ESRD) without Hepatitis C (HCV) to Accept a HCV+ Kidney. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Reese P, Goldberg D, Mussell A, McCauley M, Sawinski D, Molina N, Tomlin R, Doshi S, Abt P, Blumberg E, Thiessen C, Kulkarni S, Esnaola G. Willingness of End-Stage Renal Disease Patients (ESRD) without Hepatitis C (HCV) to Accept a HCV+ Kidney. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/willingness-of-end-stage-renal-disease-patients-esrd-without-hepatitis-c-hcv-to-accept-a-hcv-kidney/. Accessed January 18, 2021.
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