Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 21, Issue 3, Pages 1186-1196Publisher
ELSEVIER SCIENCE INC
DOI: 10.1111/ajt.16262
Keywords
donor nephrectomy; donors and donation: donor evaluation; education; health services and outcomes research; kidney disease; kidney transplantation/nephrology; kidney transplantation: living donor; organ transplantation in general; translational research/science
Categories
Funding
- National Institutes of Health [R01DK088711, T32DK104687]
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Individualized education plans can enhance patients' readiness and knowledge about living and deceased donor kidney transplants, and promote their proactive pursuit of transplantation. The study indicates that a focused and coordinated educational effort can improve transplant-seeking behaviors and waitlisting rates among patients.
Individually tailoring education over time may help more patients, especially racial/ethnic minorities, get waitlisted and pursue deceased and living donor kidney transplant (DDKT and LDKT, respectively). We enrolled 802 patients pursuing transplant evaluation at the University of California, Los Angeles Transplant Program into a randomized education trial. We compared the effectiveness of Your Path to Transplant (YPT), an individually tailored coaching and education program delivered at 4 time points, with standard of care (SOC) education on improving readiness to pursue DDKT and LDKT, transplant knowledge, taking 15 small transplant-related actions, and pursuing transplant (waitlisting or LDKT rates) over 8 months. Survey outcomes were collected prior to evaluation and at 4 and 8 months. Time to waitlisting or LDKT was assessed with at least 18 months of follow-up. At 8 months, compared to SOC, the YPT group demonstrated increased LDKT readiness (47% vs 33%, P = .003) and transplant knowledge (effect size [ES] = 0.41,P < .001). Transplant pursuit was higher in the YPT group (hazard ratio: 1.44, 95% confidence interval: 1.15-1.79, P = .002). A focused, coordinated education effort can improve transplant-seeking behaviors and waitlisting rates.
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