On the other hand, ranking the medical risks of HIV and hepatitis C in transplants as disincentives to high-risk donor use were not significant predictors of a change in practice overall, but did predict avoiding the use of high-risk donors. The odds ratios were 8.29 for HIV risk and 5.70 for hepatitis C risk, and both were significant at P<0.05.
Among physicians who changed practice, the researchers argued, most changes could be classified as "defensive medicine."
That finding is "worrisome," they noted, because high-risk donors contribute 8.6% of recovered organs and offer "significant survival benefit" despite a small risk of transmitting infectious disease.
The researchers cautioned that the data were self-reported, so it is possible that surgeons either over- or underreported changes to their practice following the 2007 event. It's also possible that those who responded to the survey differ from those who did not respond, they noted, although survey respondents represented 89.1% of U.S. transplant volume.
Finally, they cautioned that the survey took place after the 2007 case, so that recall bias is possible.
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