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Abstract: SA-PO804

Impact of Willingness to Accept a Hepatitis C Viremic Donor Kidney on Access to Transplant

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Mckinney, Warren T., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
  • Schladt, David P., Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Israni, Ajay K., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
Background

The approval of effecttve therapy for Hepatitis C (HCV) for use in transplant patients changed considerations for using organs recovered from HCV viremic donors. We evaluated the impact of kidney transplant candidates’ willingness to accept a HCV donor on access to deceased donor kidney transplant (DDKT). We also sought to determine the effect of race when considering willingness to accept a HCV donor.

Methods

This study used Scientific Registry of Transplant Recipients data, and included all candidates for DDKT between Jan. 1, 2015 and Mar. 12, 2020 (n= 233,033). Candidates were classified as African American (AA) or non-African American (non-AA) and categorial differences in clinical factors were evaluated by Χ2 tests. Cox models with time to transplant were constructed to assess the impact of willingness to accept a HCV donor and the effect combined with race. Sub-analyses evaluated the impact of geography and Latino ethnicity.

Results

76,576 (32.9%) candidates during the study period were AA, and there was significant variation in clinical factors between AA and non-AA candidates. AA candidates were more likely to: be female, blood type B, have 3 or more years of waiting time, and be willing to accept a HCV donor (all p <0.001). Willingness to accept a HCV donor was associated with increased access to transplant for all candidates, hazard ratios (HR) for non-AA access to transplant was 2.174 (95% CI, 2.097-2.254) and 2.196 (95% CI, 2.096 – 2.300) for AA (Figure 1). Similar results were seen in Latinos and across geographies.

Conclusion

Willingness to accept a HCV donor is associated with increased access to DDKT. There is an opportunity to expand access to DDKT by providing decision support for AA and non-AA candidates on accepting HCV donors. However, further analysis is necessary to disentangle the interaction between candidate selection and candidate-level risk tolerance.

Impact of willingness to accept HCV donor kidney on access to DDKT

Funding

  • Other NIH Support