The availability of organs that are positive for hepatitis C virus (HCV) can potentially decrease the length of time on organ transplantation waitlists and increase organ availability, but most patients are not willing or unsure whether they want to accept an HCV-positive organ, according to study results published in the American Journal of Nephrology.

In the era of direct-acting antiviral therapy, organs from people who have HCV are being used for transplantation in patients both with and without HCV. However, information about patient attitudes towards receiving an HCV-positive organ is limited. In this study, the researchers examined attitudes about receiving an HCV-positive organ for transplantation in 50 patients who were surveyed during a clinic visit or outpatient hemodialysis from May to December 2017.

In this cohort, 88% were waitlisted for a kidney transplant and 12% were awaiting transplantation of other organs and the median waiting time was 39.8 months (range 1.7 to 203 months). While nearly all of the patients (90%) knew what HCV was, only 60% were aware that it is now a curable disease. Less than half (46%) were willing to accept an HCV-positive organ, 30% were unsure, and 24% did not want one.  When patients who were unsure or unwilling to accept an HCV-positive organ were grouped together and compared with patients who were willing to accept the transplant, the study found that patients who would accept an HCV-positive organ were significantly older (P ≤.001), white (P =0.03), had more trust in their medical provider (P ≤.001), and had shorter waitlist times (P ≤.001).

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“These data highlight the need for greater patient education toward the use of these organs and the importance of a robust doctor-patient relationship when discussing HCV-positive organ transplantation,” concluded the researchers.

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Couri T, Cotter TG, Chen D, et al. Use of hepatitis C positive organs: patient attitudes in urban Chicago. Am J Nephrol. 2018;49(1):32-40