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. 2024 Jan 10;11(3):ofae015.
doi: 10.1093/ofid/ofae015. eCollection 2024 Mar.

Patient Perspectives on Solid Organ Transplantation From Donors With Hepatitis C Viremia to Recipients Without Hepatitis C Viremia

Karen B Vanterpool  1 , Kadiatou Diallo  1 , Ellie Kim  2 , Sarah E Van Pilsum Rasmussen  2 , Morgan A Johnson  2 , Zachary Predmore  3 , Janetta Brundage  2 , Brittany Barnaba  4 , Niraj Desai  4 , Macey L Levan  1   2   5 , Hannah C Sung  2 , Olivia Kates  4   5 , Jeremy Sugarman  3   4   6 , Christine M Durand  4
Affiliations

Patient Perspectives on Solid Organ Transplantation From Donors With Hepatitis C Viremia to Recipients Without Hepatitis C Viremia

Karen B Vanterpool et al. Open Forum Infect Dis. .

Abstract

Background: Organ transplantation from donors with hepatitis C viremia (HCV) to recipients without HCV (HCV D+/R-) has excellent medical outcomes. Less is known about the psychosocial impact and experiences of HCV D+/R- recipients, particularly outside of clinical trials.

Methods: We conducted in-depth, semistructured interviews with 24 HCV D+/R- recipients (kidney, n = 8; lung, n = 7; liver, n = 5; heart, n = 3; simultaneous heart and kidney, n = 1) who received transplants outside of clinical trials and were treated for HCV after transplant to assess their experiences and perspectives. We used thematic analysis to analyze the interviews.

Results: Interviewees' reasons for accepting an HCV D + organ were based on perceived benefits and confidence in the effectiveness of HCV treatment. The majority (62%) received HCV treatment within 1 month after transplant (range, 1 day-2 months). Most interviewees reported positive transplant outcomes, including reduced wait times and improved survival, health, physical activity, and quality of life. Overall, themes and experiences did not differ significantly between different organ transplant types. Generally, interviewees did not perceive stigma from those aware of the HCV D+ transplant; yet, disclosure was selective and a few recipients reported concerns from family members about posttransplant HCV transmission risk. Other common concerns included treatment costs and delays, which were not always anticipated by recipients.

Conclusions: Our findings suggest that HCV D+/R- kidney, liver, and heart and lung transplant recipients outside of clinical trials had overall positive experiences. However, HCV transmission risk, treatments costs, and treatment delays were a source of concern that might be mitigated with targeted pretransplant education.

Keywords: hepatitis C; infectious disease; patient experiences; solid organ transplant.

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Conflict of interest statement

Potential conflicts of interest. J. S. is a member of Merck KGaA's Ethics Advisory Panel and Stem Cell Research Oversight Committee; a member of IQVIA's Ethics Advisory Panel; a member of Aspen Neurosciences Clinical Advisory Panel; was a member of a Merck Data Monitoring Committee; and was a consultant to Biogen. None of these activities is related to the material discussed in this manuscript. C. M. D. serves on a grant review committee for Gilead Sciences, a pharmaceutical company that makes antivirals for the treatment of HCV, and she is an investigator on 2 trials of HCV transplantation to which Gilead donates drug. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Mind map of topics related to HCV treatment and HCV D+ transplant that emerged from recipient interviews. HCV, hepatitis C viremia.
See this image and copyright information in PMC

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