Direct‐acting antivirals (DAA) transformed hepatitis C virus (HCV) treatment in 2014; however, their impact on transplant candidates' willingness to accept (CWTA) organs from HCV+ donors remains uncertain. We retrospectively studied… Click to show full abstract
Direct‐acting antivirals (DAA) transformed hepatitis C virus (HCV) treatment in 2014; however, their impact on transplant candidates' willingness to accept (CWTA) organs from HCV+ donors remains uncertain. We retrospectively studied Organ Procurement and Transplantation Network data from 2008 to 2019, investigating CWTA different organs from HCV+ donors over time, using segmented multivariable logistic regression, and how that influenced wait‐time and deceased‐donor transplantation (DDTx) probability, using multivariable logistic or linear regression. We found that DAA availability was associated with a marked increase in CWTA in all organs from HCV+ donors except intestine. By December 2020, 40% of kidney, 33% of kidney‐pancreas, 42% of pancreas, over 50% of liver, heart, lung, heart‐lung, and 9% of intestine candidates waitlisted were CWTA an organ from HCV+ donors. Compared with pre‐DAA, yearly CWTA kidney from HCV+ donors increased post‐DAA 1.781.811.83‐fold, kidney–pancreas 2.52 2.78 3.07‐fold, pancreas 3.153.69 4.43‐fold, liver 1.531.541.56‐fold, heart 1.92 2.02.08 ‐fold, and lung 2.002.12.20 ‐fold. CWTA kidney and liver from HCV+ donors significantly increased DDTx probability post‐DAA (1.982.042.1‐fold and 1.241.291.33‐fold, respectively) and shortened kidney candidates’ wait‐time7890101 days (Mean with 95% CI). CWTA organs from HCV+ donors rose significantly with DAA availability, benefitting kidney and liver candidates with increased DDTx rates and shortened kidney candidates’ wait time. Further long‐term outcomes investigation and standardized organ from HCV+ donors’ education could improve both provider and patient acceptance and utilization.
               
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