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使用丙型肝炎阳性器官:芝加哥市区患者的态度。

Use of Hepatitis C Positive Organs: Patient Attitudes in Urban Chicago.

机构信息

Department of Internal Medicine, The University of Chicago Medicine, Chicago, Illinois, USA,

Department of Internal Medicine, Section of Gastroenterology, Hepatology, and Nutrition, The University of Chicago Medicine, Chicago, Illinois, USA.

出版信息

Am J Nephrol. 2019;49(1):32-40. doi: 10.1159/000495263. Epub 2018 Dec 14.

Abstract

BACKGROUND

Hepatitis C virus (HCV)-infected organs are being transplanted in patients with and without HCV in the direct-acting antiviral era. Little is known about patient attitudes towards receiving an HCV-positive organ.

OBJECTIVES

The aim of this study is to determine transplant candidates' attitudes towards receiving HCV-positive organs.

METHODS

Adult solid organ transplant candidates were identified during a clinic visit or during outpatient hemodialysis from May to December 2017. Willing participants completed a survey. Descriptive analysis including mean and median for continuous variables and frequencies for categorical variables were calculated by the appropriate statistical method and compared across willing, unsure, and unwilling patients and between willing and unsure/unwilling patients.

RESULTS

Fifty patients were surveyed with median age 54.5 years (range 32-77). Eighty-eight percent were awaiting kidney transplant, and 12% were awaiting other organs. Median waitlist time was 39.8 months (range 1.7-203 months). Most patients (90%) had prior knowledge of HCV, but only 60% knew it was curable. Forty-six percent were willing, 30% were unsure, and 24% were unwilling to receive an HCV-positive organ. Those willing to accept an HCV-positive organ were significantly older, Caucasian, had shorter waitlist times, and had greater physician trust than those that were unsure/unwilling. Similar worries, such as HCV incurability, insurance coverage, fears over the organ not working, and post-transplant death, were expressed in both the willing and unsure/unwilling patients.

CONCLUSIONS

The availability of HCV-positive organs may expand the donor pool and decrease waitlist times and mortality. These data highlight the need for patient education towards use of these organs.

摘要

背景

在直接作用抗病毒时代,患有和不患有丙型肝炎病毒(HCV)的患者都在接受 HCV 感染器官的移植。对于患者对接受 HCV 阳性器官的态度知之甚少。

目的

本研究旨在确定移植候选人对接受 HCV 阳性器官的态度。

方法

2017 年 5 月至 12 月,在诊所就诊或门诊血液透析期间确定成年实体器官移植候选人。愿意参与的患者完成了一项调查。通过适当的统计方法计算连续变量的平均值和中位数以及分类变量的频率,并按愿意、不确定和不愿意患者进行比较,并在愿意和不确定/不愿意患者之间进行比较。

结果

对 50 名患者进行了调查,中位年龄为 54.5 岁(范围 32-77 岁)。88%的患者等待肾移植,12%的患者等待其他器官。中位候补名单时间为 39.8 个月(范围 1.7-203 个月)。大多数患者(90%)之前了解 HCV,但只有 60%知道它是可治愈的。46%的患者愿意,30%的患者不确定,24%的患者不愿意接受 HCV 阳性器官。愿意接受 HCV 阳性器官的患者明显年龄较大,为白种人,候补名单时间较短,对医生的信任度高于不确定/不愿意的患者。愿意和不确定/不愿意的患者都表达了类似的担忧,如 HCV 不可治愈性、保险覆盖范围、担心器官无法正常工作以及移植后死亡。

结论

HCV 阳性器官的可用性可能会扩大供体库,减少候补名单时间和死亡率。这些数据强调了对这些器官进行患者教育的必要性。

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