Transplanting HCV-Positive Kidneys Into HCV-Negative Recipients: What Do We Know?
Med-IQ Express Med-IQ Express

Transplanting HCV-Positive Kidneys Into HCV-Negative Recipients: What Do We Know?


This activity was developed by Med-IQ in collaboration with Duke Health.

Med-IQ      Duke Medicine
 

Released:
12/17/19
Expires:
12/16/20

Maximum Credits:

0.25
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Med-IQ Express Med-IQ Express
By clicking "Continue," you are confirming that you have reviewed the CME information and read, understood, and unconditionally agreed to the Privacy Notice and Terms of Use.
Released:
12/17/19

Expires:
12/16/20

Maximum Credits:
0.25
Med-IQ Express Med-IQ Express
By clicking "Continue," you are confirming that you have reviewed the CME information and read, understood, and unconditionally agreed to the Privacy Notice and Terms of Use.

Released:
12/17/19
Expires:
12/16/20


Maximum Credits:
0.25


Overview: This brief accredited CME publication examines the rationale and current evidence for the transplantation of kidneys from hepatitis C virus (HCV)–positive donors into HCV-negative recipients. In particular, it explores changes in the characteristics of the donor pool due to the ongoing opioid crisis and reviews short- to intermediate-term outcomes from ongoing prospective trials. The efficacy and safety of treatment with direct-acting antiviral (DAA) agents is also discussed. Additionally, this publication features a short video clip of expert perspectives on transplanting HCV-positive kidneys into HCV-negative recipients before and after the emergence of DAAs and briefly explores outcomes from the EXPANDER-1 and THINKER-1 prospective trials.

CME Information:

Faculty
Scott L. Sanoff, MD, MPH
Assistant Professor of Medicine
Division of Nephrology
Duke Transplant Center
Duke University Health System
Durham, NC
 
Activity Planners
Erin Mooney, MS
Clinical Content Manager
Med-IQ
Baltimore, MD

Laura Rafferty, ELS
Managing Editor
Med-IQ
Baltimore, MD

Samantha Gordon
CME Specialist
Med-IQ
Baltimore, MD

Kathryn Schaefer, MSN, RN, CPHRM
Senior Manager, Accreditation and Compliance
Med-IQ
East Lansing, MI
 
Writer
Jennifer Gregg, PhD
Cranberry Township, PA
 
Learning Objectives
Upon completion, participants should be able to:

  • Describe current clinical evidence regarding the short- and intermediate-term outcomes associated with transplanting organs from HCV-positive donors into patients who are HCV negative

Target Audience
This activity is intended for nephrologists.
 
Statement of Need
The number of patients awaiting kidney transplantation—as well as the wait time—has continued to rise for the past 2 decades. This has led to the current reality that just 14% of the more than 94,000 patients on the kidney waiting list will receive a kidney transplant, meaning 13 people will die every day while waiting for a kidney donor. In recent years, due to the opioid crisis, the number of organ donations from overdose-related deaths has increased dramatically. In fact, from 2005 to 2018, the percentage of overdose donors in the donor pool increased from approximately 2% to more than 13%, leading to an increase in available organs from young donors. However, there is currently a syndemic of increased opioid use and HCV infection, and those who use intravenous opioids have the highest risk in the nation of HCV infection. HCV-positive donor kidneys have historically been disqualified for transplant except in cases where a potential recipient is HCV positive. In the era of highly effective and safe DAA agents for HCV treatment, which are associated with cure rates of more than 90%, several trials are evaluating outcomes associated with the transplantation of kidneys from HCV-positive donors into HCV-negative patients followed by DAA therapy. Results from the THINKER-1 and the EXPANDER-1 trials have recently been released and suggest that the use of kidneys from HCV-positive donors is a safe option for patients who require kidney transplantation.

Collaboration Statement
This activity was developed by Med-IQ in collaboration with Duke Health.
 
Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
 
Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
Medium/Method of Participation
This CME activity consists of a 0.25-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
 
Initial Release Date: December 17, 2019
Expiration Date: December 16, 2020
Estimated Time to Complete This Activity: 15 minutes

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 
 
Scott L. Sanoff, MD, MPH, has indicated no real or apparent conflicts.
 
The writer, peer reviewers, and activity planners have no financial relationships to disclose.
 
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, it is the policy of Med-IQ to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.
 
Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.
 
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For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email info@med-iq.com.

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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