Decision-making Among Hepatitis C Virus-negative Transplant Candidates Offered Organs from Donors with HCV Infection. Issue 8 (19th July 2022)

• Record Type: Journal Article
• Authors: Saine, M. Elle; Schnellinger, Erin M.; Liu, Michel; Diamond, Joshua M.; Crespo, Maria M.; Prenner, Stacey; Potluri, Vishnu; Bermudez, Christian; Mentch, Heather; Moore, Michaella; Besharatian, Behdad; Goldberg, David S.; Barg, Frances K.; Reese, Peter P.
• Is Part Of: Transplantation direct. Volume 8:Issue 8(2022)
• Page Start: e1341
• Publication Date: 2022-07-19
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation -- Periodicals; 362.19795
• DOI: 10.1097/TXD.0000000000001341
• Languages: English
• ISSNs: 2373-8731

Abstract

Abstract : Background: Historically, many organs from deceased donors with hepatitis C virus (HCV) were discarded. The advent of highly curative direct-acting antiviral (DAA) therapies motivated transplant centers to conduct trials of transplanting HCV-viremic organs (nucleic acid amplification test positive) into HCV-negative recipients, followed by DAA treatment. However, the factors that influence candidates' decisions regarding acceptance of transplant with HCV-viremic organs are not well understood. Methods: To explore patient-level perceptions, influences, and experiences that inform candidate decision-making regarding transplant with organs from HCV-viremic donors, we conducted a qualitative semistructured interview study embedded within 3 clinical trials investigating the safety and efficacy of transplanting lungs and kidneys from HCV-viremic donors into HCV-negative recipients. The study was conducted from June 2019 to March 2021. Results: Among 44 HCV-negative patients listed for organ transplant who were approached for enrollment in the applicable clinical trial, 3 approaches to decision-making emerged: positivist, risk analyses, and instinctual response. Perceptions of risk contributed to conceptualizations of factors influencing decisions. Moreover, most participants relied on multiple decision-making approaches, either simultaneously or sequentially. Conclusions: Understanding how different decisional models influence patients' choices regarding transplant with organs from HCV-viremic donors may promote shared decision-making among transplant patients and providers.