Ek Khoon Tan, Ye Xin Koh, Terence Kee, Juhainah Binte Juhari, Teing Ee Tan, David Kheng Leng Sim, Aloysius Yew Leng Ho, Lalitha Krishnan, Ping Sing Tee, Thinesh Lee Krishnamoorthy, Brian Kim Poh Goh, Ban Hock Tan, Shimin Jasmine Chung, Ghee Chee Phua, Prema Raj Jeyaraj
Department of Hepato-Pancreato-Biliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
Ann Transplant 2020; 25:e926992
Available online: 2020-10-01
In solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, coronavirus disease 2019 (COVID-19) can contribute to a severe clinical course and an increased risk of death. Thus, patients awaiting a SOT or HSCT face the dilemma of choosing between a life-saving treatment that presents a significant threat of COVID-19 and the risk of waitlist dropout, progression of disease, or mortality. The lack of established literature on COVID-19 complicates the issue as patients, particularly those with inadequate health literacy, may not have the resources needed to navigate these decisions.
MATERIAL AND METHODS: We conducted a standardized phone survey of patients awaiting SOT or HSCT to assess the prevalence of inadequate health literacy and attitudes toward transplant during the COVID-19 pandemic.
RESULTS: Seventy-one patients completed the survey, with a response rate of 84.5%. Regardless of health literacy, most waitlisted candidates recognized that the current pandemic is a serious situation affecting their care and that COVID-19 poses a significant risk to their health. Despite the increased risks, most patients reported they would choose immediate transplantation if there was no foreseeable end to the pandemic, and especially if the medical urgency did not permit further delay. There were no differences in responses across the patient waitlist groups for heart, kidney, liver, and stem cell transplant.
CONCLUSIONS: These findings can help transplant centers decide how transplantation services should proceed during this pandemic and can be used to educate patients and guide discussions about informed consent for transplant during the COVID-19 pandemic.
Keywords: Health Care Surveys, Health Literacy, Transplantation