Optimal Transplant Education for Recipients to Increase Pursuit of Living Donation

Waterman, Amy D.; Barrett, Ann; Stanley, Sara

doi:10.1177/152692480801800111

Cited by 64 publications

(53 citation statements)

References 37 publications

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“…If not supplied with these skills, patients eligible for kidney transplant may prefer to wait for volunteers to approach them than to ask anyone directly. 16,45 …”

Section: Discussionmentioning

confidence: 99%

African American Kidney Transplant Patients' Perspectives on Challenges in the Living Donation Process

et al. 2015

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Context The increasing shortage of deceased donor kidneys suitable for African Americans highlights the critical need to increase living donations among African Americans. Little research has addressed African American transplant recipients’ perspectives on challenges and barriers related to the living donation process. Objective To understand the perspectives of African American recipients of deceased and living donor kidney transplants on challenges, barriers, and educational needs related to pursuing such transplants. Participants and Design A mixed-method design involved 27 African American kidney recipients (13 male) in 4 focus groups (2 per recipient type: 16 African American deceased donor and 11 living donor recipients) and questionnaires. Focus group transcripts were evaluated with NVivo 10.0 (QSR, International) by using inductive and deductive qualitative methods along with crystallization to develop themes of underlying barriers to the living donor kidney transplant process and were compared with the questionnaires. Results Four main themes were identified from groups: concerns, knowledge and learning, expectations of support, and communication. Many concerns for the donor were identified (eg, process too difficult, financial burden, effect on relationships). A general lack of knowledge about the donor process and lack of behavioral skills on how to approach others was noted. The latter was especially evident among deceased donor recipients. Findings from the questionnaires on myths and perceptions supported the lack of knowledge in a variety of domains, including donors’ surgical outcomes risks, costs of surgery, and impact on future health. Participants thought that an educational program led by an African American recipient of a living donor kidney transplant, including practice in approaching others, would increase the likelihood of transplant-eligible patients pursuing living donor kidney transplant.

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“…If not supplied with these skills, patients eligible for kidney transplant may prefer to wait for volunteers to approach them than to ask anyone directly. 16,45 …”

Section: Discussionmentioning

confidence: 99%

African American Kidney Transplant Patients' Perspectives on Challenges in the Living Donation Process

et al. 2015

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“…18,19 Participants’ engagement in transplant learning activities was assessed by self-report. Participants reported the type of educational activity and the time spent on each activity.…”

Section: Methodsmentioning

confidence: 99%

Has the Department of Veterans Affairs Found a Way to Avoid Racial Disparities in the Evaluation Process for Kidney Transplantation?

et al. 2017

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Background Minority groups are affected by significant disparities in kidney transplantation (KT) in Veterans Affairs (VA) and non-VA transplant centers. But, prior VA studies have been limited to retrospective, secondary database analyses that focused on multiple stages of the KT process simultaneously. Our goal was to determine whether disparities during the evaluation period for KT exist in the VA as has been found in non-VA settings. Methods We conducted a multi-center longitudinal cohort study of 602 patients undergoing initial evaluation for KT at 4 National VA KT Centers. Participants completed a telephone interview to determine whether, after controlling for medical factors, differences in time to acceptance for transplant were explained by patients' demographic, cultural, psychosocial, or transplant knowledge factors. Results There were no significant racial disparities in the time to acceptance for KT [Log-Rank χ2 =1.04; p=0.594]. Younger age (HR 0.98; 95% CI 0.97–0.99), fewer comorbidities (HR 0.89; 95% CI 0.84–0.95), being married (HR 0.81; 95% CI 0.66–0.99), having private and public insurance (HR 1.29; 95% CI 1.03–1.51), and moderate or greater levels of depression (HR 1.87; 95% CI 1.03–3.29) predicted a shorter time to acceptance. The influence of preference for type of KT (deceased or living donor) and transplant center location on days to acceptance varied over time. Conclusions Our results indicate that the VA National Transplant System did not exhibit the racial disparities in evaluation for KT as have been found in non-VA transplant centers.

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“…Given that LDKT is the best treatment for most patients with ESRD, it seems appropriate to increase time spent on LDKT education, to begin education earlier in the disease process (e.g., delivered by general nephrologists and dialysis providers), and to re-discuss LDKT at various time-points (e.g., CKD diagnosis, dialysis initiation, transplant evaluation, while on waiting list). [9] Different combinations of LDKT educational content, amount of time spent, and delivery approaches have been evaluated with transplant candidates. [10–12] These trials have demonstrated techniques that result in improved knowledge of and more positive attitudes about LDKT, successful completion of transplant evaluation, increased LKD evaluations, and/or higher LDKT rates.…”

Section: Transplant Candidate Ldkt Educational Processesmentioning

confidence: 99%

Consensus Conference on Best Practices in Live Kidney Donation: Recommendations to Optimize Education, Access, and Care

Rudow

Hays

Baliga

et al. 2015

American Journal of Transplantation

173

171

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Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5–6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation.

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Optimal Transplant Education for Recipients to Increase Pursuit of Living Donation

Cited by 64 publications

References 37 publications

African American Kidney Transplant Patients' Perspectives on Challenges in the Living Donation Process

African American Kidney Transplant Patients' Perspectives on Challenges in the Living Donation Process

Has the Department of Veterans Affairs Found a Way to Avoid Racial Disparities in the Evaluation Process for Kidney Transplantation?

Consensus Conference on Best Practices in Live Kidney Donation: Recommendations to Optimize Education, Access, and Care

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