Waitlisted Transplant Candidates’ Attitudes and Concerns Toward Transplantation During COVID-19

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

doi:10.12659/AOT.926992

08 December 2020 : Original article

Waitlisted Transplant Candidates’ Attitudes and Concerns Toward Transplantation During COVID-19

Ek Khoon Tan^12ABCDEF*, Ye Xin Koh^12ABE, Terence Kee^23ADEF, Juhainah Binte Juhari^2ABE, Teing Ee Tan^45ADE, David Kheng Leng Sim^26ADE, Aloysius Yew Leng Ho^26ADE, Lalitha Krishnan^2ABE, Ping Sing Tee^2ABE, Thinesh Lee Krishnamoorthy^27ADEF, Brian Kim Poh Goh^12ADE, Ban Hock Tan^89ADEF, Shimin Jasmine Chung^29ADEF, Ghee Chee Phua^210ADE, Prema Raj Jeyaraj^112ADE

DOI: 10.12659/AOT.926992

Ann Transplant 2020; 25:e926992

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Table 3 Patient responses to questions on COVID-19 vs. presence of IHL (n=71).

		Entire cohort (n=71)	IHL \|(n=34)	Non-IHL (n=37)	p-Value


1) Do you think that the COVID-19 situation is serious in Singapore?	Yes	81.7	76.5	86.5	0.54
	No	14.1	17.6	10.8
	Do not know	4.2	5.9	2.7

2) Do you think that the COVID-19 situation is serious globally?	Yes	93.0	91.2	94.6	0.57
	No	5.6	5.9	5.4
	Do not know	1.4	2.9	0

3) Do you think that this COVID-19 situation will last less than a year?	Yes	31.0	44.1	18.9	0.07
	No	52.1	44.1	59.5
	Do not know	16.9	11.8	21.6

4) Do you think that the COVID-19 situation will last beyond a year?	Yes	59.2	52.9	64.9	0.43
	No	25.4	32.4	18.9
	Do not know	15.5	14.7	16.2



5) Do you feel hopeful of getting a transplant? (i.e. An organ will eventually come to you)	Yes	73.2	70.6	75.7	0.71
	No	12.7	11.8	13.5
	Do not know	14.1	17.6	10.8

6) Are you aware that you can drop out of the waiting list if your condition changes such that you are not suitable for transplant?	Yes	78.9	85.3	73.0	0.42
	No	11.3	8.8	13.5
	Do not know	9.9	5.9	13.5

7) Do you personally think that you will drop out of the waiting list (death or progression of disease) before you get called for an organ?	Yes	16.9	17.6	16.2	0.94
	No	57.7	58.8	56.8
	Do not know	25.4	23.5	27.0



8) Do you think that organ transplantation should continue during this time?	Yes	70.4	70.6	70.3	0.47
	No	19.7	23.5	16.2
	Do not know	9.9	5.9	13.5

9) Do you think COVID-19 is reducing your chance of getting a transplant?	Yes	56.3	58.8	54.1	0.48
	No	29.6	23.5	35.1
	Do not know	14.1	17.6	10.8

10) Would you undergo an organ transplant now if an organ becomes available?	Yes	83.1	85.3	81.1	0.76
	No	8.5	8.8	8.1
	Do not know	8.5	5.9	10.8

11) Do you think that it is easier for a transplanted patient to contract COVID-19 compared to a regular person? (If both were similarly exposed to patient with COVID-19)	Yes	69.0	70.6	67.6	0.44
	No	16.9	11.8	21.6
	Do not know	14.1	17.6	10.8

12) Do you think a COVID-19 infection is more dangerous for a transplanted patient? (compared to a regular person)	Yes	83.1	85.3	81.1	0.76
	No	8.5	8.8	8.1
	Do not know	8.5	5.9	10.8



13) Do you think it is safe to receive organs from a COVID-19 positive donor?	Yes	8.5	11.8	5.4	0.06
	No	71.8	58.8	83.8
	Do not know	19.7	29.4	10.8

14) Do you think it is possible for COVID-19 to transmit via organ transplantation?	Yes	54.9	61.8	48.6	0.41
	No	9.9	5.9	13.5
	Do not know	35.2	32.4	37.8

15) Do you feel confident that the donor can be adequately tested to exclude COVID-19?	Yes	70.4	64.7	75.7	0.39
	No	9.9	14.7	14.7
	Do not know	19.7	20.6	20.6

16) All tests are imperfect. There is a chance that the donor can have COVID-19 even if the tests are negative (just like HIV, HCV). Knowing that, even though the chance is very small, would you still agree to a transplant?	Yes	66.2	70.6	62.2	0.38
	No	15.5	17.6	17.6
	Do not know	18.3	11.8	11.8



17) Do you feel that your hospital is taking adequate precautions in protecting you from hospital acquired COVID-19 infection?	Yes	95.8	100	91.9	0.24
	No	2.8	0	5.4
	Do not know	1.4	0	2.7

18) If you are admitted for transplant, would you be worried about catching COVID-19 from other patients?	Yes	40.8	50.0	32.4	0.26
	No	53.5	47.1	59.5
	Do not know	5.6	2.9	8.1

19) If you are admitted for transplant, would you be worried about catching COVID-19 from healthcare staff?	Yes	35.2	38.2	32.4	0.17
	No	54.9	58.8	51.4
	Do not know	9.9	2.9	16.2

20) Would you undergo a transplant at a hospital that is treating COVID-19 patients?	Yes	67.6	70.6	64.9	0.88
	No	22.5	20.6	24.3
	Do not know	9.9	8.8	10.8

21) Would you undergo an organ transplant now if you cannot have visitors during your hospitalization?	Yes	70.4	73.5	67.6	0.38
	No	26.8	26.5	27.0
	Do not know	2.8	0.0	5.4

22) Are you concerned about travelling to and from the hospital after transplant during this time?	Yes	29.6	32.4	27.0	0.62
	No	70.4	67.6	73.0
	Do not know	0	0	0

23) Are you concerned that COVID-19 will affect your ability to get your medications?	Yes	19.7	20.6	18.9	0.56
	No	78.9	76.5	81.1
	Do not know	1.4	2.9	0

24) Are you concerned that your caregiver is at increased risk of contracting COVID-19 if you undergo a transplant?	Yes	36.6	38.2	35.1	0.80
	No	53.5	50.0	56.8
	Do not know	9.9	11.8	8.1

25) Healthcare workers will have to travel around the country in order to perform organ donation procedures. Do you think this puts them at risk of contracting COVID-19?	Yes	62.0	58.8	64.9	0.85
	No	15.5	17.6	13.5
	Do not know	22.5	23.5	21.6

26) Since healthcare workers must travel around the country for organ donation, do you think that organ transplantation should continue?	Yes	73.2	70.6	75.7	0.10
	No	12.7	20.6	5.4
	Do not know	14.1	8.8	18.9



27) Since COVID-19 is everywhere, do you think that the process of transplant will put you at an increased risk of contracting COVID-19?	Yes	56.3	61.8	51.4	0.46
	No	36.6	29.4	29.4
	Do not know	7.0	8.8	8.8

28) Would you rather wait till the whole COVID-19 situation is over before going for transplant?	Yes	38.0	44.1	32.4	0.53
	No	47.9	41.2	54.1
	Do not know	14.1	14.7	13.5

29) If, you receive an organ offer today, and there is no foreseeable end to COVID-19, will you proceed with transplant?	Yes	71.8	70.6	73.0	0.18
	No	16.9	23.5	10.8
	Do not know	11.3	5.9	16.2

30) If, you receive an organ offer today, and know that you cannot wait that long (medically) for COVID-19 to end, will you proceed with transplant?	Yes	87.3	82.4	91.9	0.38
	No	11.3	14.7	8.1
	Do not know	1.4	2.9	0
IHL – inadequate health literacy.

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Waitlisted Transplant Candidates’ Attitudes and Concerns Toward Transplantation During COVID-19

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