Transplantation: Research Article Am J Nephrol 2019;50:168–176 Provider Attitudes toward the Use of Hepatitis C Virus-Positive Organs in Kidney Transplantation Thomas Couri a Joshua Katz a Kate Stoeckle b Aishwarya Nugooru c Heidi Yeh d Raymond Chung e Sonali Paul f a Department of Internal Medicine, University of Chicago Medical Center, Chicago, IL, USA; b New York Presbyterian/ Weill Cornell Medical Center, Department of Internal Medicine, New York, NY, USA; c Virginia Commonwealth University Medical School, Richmond, VA, USA; d Department of Surgery, Section of Transplant Surgery, Massachusetts General Hospital, Boston, MA, USA; e Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; f Center for Liver Diseases, University of Chicago, Chicago, IL, USA Received: May 19, 2019 Accepted: July 8, 2019 Published online: August 7, 2019 Nephrolo gy American Journal of Thomas Couri, MD Department of Internal Medicine University of Chicago Medical Center 5841 South Maryland Avenue, Chicago, IL 60637 (USA) E-Mail Thomas.couri @uchospitals.edu © 2019 S. Karger AG, Basel E-Mail karger@karger.com www.karger.com/ajn DOI: 10.1159/000502049 Keywords Hepatitis C · Organ allocation · Kidney transplantation · Provider education Abstract Background: Direct-acting antivirals have changed the landscape of hepatitis C virus (HCV) care. While transplanta- tion with HCV-positive donor organs is increasing, little is known about providers’ attitudes toward this topic. The aim of this study is to determine providers’ attitudes toward HCV-positive kidney transplantation. Methods: Willing transplant and nontransplant nephrologists, transplant sur- geons, and mid-level providers completed an online survey from April through May 2018. The survey asked about HCV knowledge and willingness to transplant HCV-positive anti- body, nucleic acid testing-positive kidneys into HCV-nega- tive recipients. Descriptive analyses including mean and me- dian for continuous variables and frequencies for categorical variables were calculated. Results: Seven-hundred surveys were emailed and 99 providers (62 transplant nephrologists, 28 nontransplant nephrologists, 7 transplant surgeons, and 2 advanced practice providers) completed the survey (par- ticipation rate 14.1%). All providers knew that HCV was cur- able, with 60% believing that it had no effect on transplant success and 32% thinking it reduced transplant success. Pro- viders were significantly more likely to offer a HCV-positive organ to HCV-positive recipients compared to HCV-negative recipients in all queried circumstances (p < 0.005 in all cases), especially with increasing impact on patient’s quality of life. While only 39% of providers would offer a HCV-positive or- gan for transplant to a patient without HCV if it reduced the waitlist time by 1 year, 92% would offer a HCV-positive organ if it reduced the waitlist time by 4 years. However, only 47% thought that the use of HCV-positive kidneys should be for routine care, while 38% believed it should be reserved for research purposes only. There were no significant differenc- es between transplant and nontransplant nephrologists in attitudes toward HCV-positive kidney transplantation. Pro- viders believed that donor organs from those who were obese, >50 years old, or had died from a cardiac arrest were T.C. and J.K. co-first authors.