Journal article
Survey of Clinician Opinions on Kidney Transplantation from Hepatitis C Virus Positive Donors: Identifying and Overcoming Barriers
Kidney360, Vol.1(11), pp.1291-1299
11/2020
DOI: 10.34067/KID.0004592020
PMCID: PMC7695231
PMID: 33251523
Abstract
Transplant practices related to use of organs from Hepatitis C virus infected donors (DHCV+) is evolving rapidly.
We surveyed U.S. kidney transplant programs by email and professional society listserv postings between 7/19-1/20 to assess attitudes, management strategies, and barriers related to use of viremic (nucleic acid testing (NAT)+) donor organs in HCV uninfected recipients.
Staff at 112 unique programs responded, representing 54% of U.S. adult kidney transplant programs and 69% of adult deceased donor kidney transplant volume in 2019. Most survey respondents were transplant nephrologists (46%) or surgeons (43%). Among responding programs, 67% currently transplant DHCV antibody+/NAT- organs under a clinical protocol or as standard of care. By comparison, only 58% offer DHCV NAT+ kidney transplant to HCV- recipients, including 35% under clinical protocols, 14% as standard of care, and 9% under research protocols. Following transplant of DHCV NAT+ organs to uninfected recipients, 53% start direct acting antiviral agent (DAA) therapy after discharge and documented viremia. Viral monitoring protocols after DHCV NAT+ to HCV uninfected recipient kidney transplantation varied substantially. 56% of programs performing these transplants report having an institutional plan to provide DAA treatment if declined by the recipient's insurance. Respondents felt a mean decrease in waiting time of ≥18 months (range 0-60) justifies the practice. Program concerns related to use of DHCV NAT+ kidneys include insurance coverage concerns (72%), cost (60%), and perceived risk of transmitting resistant infection (44%).
Addressing knowledge about safety and logistical/financial barriers related to use of DHCV NAT+ kidney transplantation for HCV uninfected recipients may help reduced discards and expand the organ supply.
Details
- Title: Subtitle
- Survey of Clinician Opinions on Kidney Transplantation from Hepatitis C Virus Positive Donors: Identifying and Overcoming Barriers
- Creators
- Krista L Lentine - Saint Louis UniversityJohn D Peipert - Northwestern UniversityTarek Alhamad - Washington University in St. LouisYasar Caliskan - Saint Louis UniversityBeatrice P Concepcion - Vanderbilt University Medical CenterRachel Forbes - Vanderbilt University Medical CenterMark Schnitzler - Saint Louis UniversitySu-Hsin Chang - Washington University in St. LouisMatthew Cooper - MedStar Georgetown University HospitalRoy D Bloom - University of PennsylvaniaRoslyn B Mannon - University of Nebraska at OmahaDavid A Axelrod - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Kidney360, Vol.1(11), pp.1291-1299
- DOI
- 10.34067/KID.0004592020
- PMID
- 33251523
- PMCID
- PMC7695231
- ISSN
- 2641-7650
- eISSN
- 2641-7650
- Grant note
- R01 DK120518 / NIDDK NIH HHS
- Language
- English
- Date published
- 11/2020
- Academic Unit
- Surgery
- Record Identifier
- 9984322904302771
Metrics
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