Post-transplant survey to assess patient experiences with donor-derived HCV infection.
DAA cost
HCV organ transplant
consent
donor-derived HCV
education
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
17
02
2020
revised:
24
05
2020
accepted:
29
06
2020
pubmed:
8
7
2020
medline:
12
8
2021
entrez:
8
7
2020
Statut:
ppublish
Résumé
Despite increased utilization of hepatitis C virus-infected (HCV+) organs for transplantation into HCV-uninfected recipients, there is lack of standardization in HCV-related patient education/consent and limited data on financial and social impact on patients. We conducted a survey on patients with donor-derived HCV infection at our center transplanted between 4/1/2017 and 11/1/2019 to assess: why patients chose to accept HCV+ organ(s), the adequacy of their pre-transplant HCV education and informed consent process, financial issues related to copays after discharge, and social challenges they faced. Among 49 patients surveyed, transplanted organs included heart (n = 19), lung (n = 9), kidney (n = 11), liver (n = 4), heart/kidney (n = 4), and liver/kidney (n = 2). Many recipients accepted an HCV-viremic (HCV-V) organ due to perceived reduction in waitlist time (n = 33) and/or trust in their physician's recommendation (n = 29). Almost all (n = 47) felt that pre-transplant education and consent was appropriate. Thirty patients had no copay for direct-acting antivirals (DAA) for HCV, including 21 with household income <$20 000; seven had copays of <$100 and one had a copay >$1000. Two patients reported feeling isolated due to HCV infection and eight reported higher than anticipated medication costs. Patients' biggest concern was potential HCV transmission to partners (n = 18) and family/friends (n = 15). Overall almost all (n = 47) patients reported a positive experience with HCV-V organ transplantation. We demonstrate that real-world patient experiences surrounding HCV-V organ transplantation have been favorable. Almost all patients report comprehensive HCV-related pre-transplant consent and education. Additionally, medication costs and social isolation/exclusion were not barriers to the use of these organs.
Sections du résumé
BACKGROUND
BACKGROUND
Despite increased utilization of hepatitis C virus-infected (HCV+) organs for transplantation into HCV-uninfected recipients, there is lack of standardization in HCV-related patient education/consent and limited data on financial and social impact on patients.
METHODS
METHODS
We conducted a survey on patients with donor-derived HCV infection at our center transplanted between 4/1/2017 and 11/1/2019 to assess: why patients chose to accept HCV+ organ(s), the adequacy of their pre-transplant HCV education and informed consent process, financial issues related to copays after discharge, and social challenges they faced.
RESULTS
RESULTS
Among 49 patients surveyed, transplanted organs included heart (n = 19), lung (n = 9), kidney (n = 11), liver (n = 4), heart/kidney (n = 4), and liver/kidney (n = 2). Many recipients accepted an HCV-viremic (HCV-V) organ due to perceived reduction in waitlist time (n = 33) and/or trust in their physician's recommendation (n = 29). Almost all (n = 47) felt that pre-transplant education and consent was appropriate. Thirty patients had no copay for direct-acting antivirals (DAA) for HCV, including 21 with household income <$20 000; seven had copays of <$100 and one had a copay >$1000. Two patients reported feeling isolated due to HCV infection and eight reported higher than anticipated medication costs. Patients' biggest concern was potential HCV transmission to partners (n = 18) and family/friends (n = 15). Overall almost all (n = 47) patients reported a positive experience with HCV-V organ transplantation.
CONCLUSION
CONCLUSIONS
We demonstrate that real-world patient experiences surrounding HCV-V organ transplantation have been favorable. Almost all patients report comprehensive HCV-related pre-transplant consent and education. Additionally, medication costs and social isolation/exclusion were not barriers to the use of these organs.
Identifiants
pubmed: 32634289
doi: 10.1111/tid.13402
pmc: PMC10084045
mid: NIHMS1809962
doi:
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13402Subventions
Organisme : NIAID NIH HHS
ID : T32 AI007036
Pays : United States
Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
J Viral Hepat. 2019 Dec;26(12):1362-1371
pubmed: 31111619
N Engl J Med. 2014 Dec 18;371(25):2375-82
pubmed: 25386767
N Engl J Med. 2017 Jun 15;376(24):2394-2395
pubmed: 28459186
Am J Nephrol. 2019;49(1):32-40
pubmed: 30554209
Ann Intern Med. 2020 Jan 21;172(2 Suppl):S7-S32
pubmed: 31958805
Transpl Infect Dis. 2019 Dec;21(6):e13194
pubmed: 31609520
Am J Respir Crit Care Med. 2018 Jun 1;197(11):1492-1496
pubmed: 29412687
PLoS One. 2015 Aug 27;10(8):e0135645
pubmed: 26312999
Clin J Am Soc Nephrol. 2010 May;5(5):917-23
pubmed: 20338966
Am J Gastroenterol. 2017 Jun;112(6):828-832
pubmed: 28374816
Clin Infect Dis. 2013 Aug;57 Suppl 2:S51-5
pubmed: 23884066
Liver Transpl. 2018 Jun;24(6):831-840
pubmed: 29624894
Am J Transplant. 2020 Jan;20(1):289-297
pubmed: 31394016
Ann Intern Med. 2018 Apr 17;168(8):533-540
pubmed: 29507971
J Heart Lung Transplant. 2019 Sep;38(9):907-917
pubmed: 31495408
Clin Gastroenterol Hepatol. 2016 Jul;14(7):1035-43
pubmed: 27062903
J Heart Lung Transplant. 2018 Jun;37(6):763-769
pubmed: 29530322
Hepatology. 2020 Jul;72(1):32-41
pubmed: 31659775
Circ Heart Fail. 2018 Dec;11(12):e005276
pubmed: 30562093
Liver Transpl. 2018 Jan;24(1):12-14
pubmed: 29160931
J Am Soc Nephrol. 2019 Oct;30(10):1939-1951
pubmed: 31515244
Clin Transplant. 2018 Oct;32(10):e13365
pubmed: 30074638
J Acquir Immune Defic Syndr. 2020 Sep 1;85(1):88-92
pubmed: 32427721
J Heart Lung Transplant. 2019 Dec;38(12):1259-1267
pubmed: 31521479
Transplantation. 2018 Apr;102(4):e163-e170
pubmed: 29346260
Hepatology. 2019 Jun;69(6):2381-2395
pubmed: 30706517
Ann Intern Med. 2018 Sep 4;169(5):273-281
pubmed: 30083748
Am J Transplant. 2019 Sep;19(9):2533-2542
pubmed: 30768838
Clin Transplant. 2019 Dec;33(12):e13739
pubmed: 31648391
Am J Transplant. 2019 May;19(5):1380-1387
pubmed: 30378723