Transplant professionals' perceptions of long-term care residents' candidacy for kidney transplantation

Megan Urbanski, Teri Browne, Mythili Ghanta, Serban Constantinescu, Avrum Gillespie, Heather Hammer, Heather Traino

Research output: Contribution to journalArticle

Abstract

Context: Given the aging end-stage renal disease (ESRD) population, kidney transplant (KTx) centers may experience an increase in referrals of patients living in long-term care (LTC) settings (eg, skilled nursing facilities, assisted living facilities, group homes, and boarding homes). Objective: To identify best practices among KTx professionals when considering individuals in LTC settings for transplantation. Design and Setting: A cross-sectional survey administered online to US transplant professionals via e-mail LISTSERVs and other professional networks. Participants: One hundred twenty-six KTx professionals working in the United States. Main Outcome Measures: The survey was composed of demographic questions and 6 hypothetical scenarios. These scenarios asked participants to assess transplant candidacy of patients with ESRD living in LTC settings based on the information provided in the scenario. Each scenario presented a different variable that necessitated LTC placement, including lack of social support, moderate intellectual disability, stable neurological condition, mild dementia, a psychiatric condition controlled on medications, and limited mobility. Results: The only scenario that elicited an overwhelmingly negative response was mild dementia with 73.9% of participants unwilling to consider such patients for KTx. By contrast, the proportion of KTx professionals reluctant to proceed with KTx in the remaining scenarios ranged between 40.0% and 50.6%. Conclusions: This survey of a large number of KTx professionals suggests that there is presently no best practice consensus regarding offering KTx to patients living in LTC settings. Further research should include a broader range of KTx professionals and should also include a study of outcomes with KTx in this particular patient population.

Original languageEnglish (US)
Pages (from-to)146-151
Number of pages6
JournalProgress in Transplantation
Volume27
Issue number2
DOIs
Publication statusPublished - Jan 1 2017

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Keywords

  • Kidney transplantation
  • Long-term care
  • Older adults
  • Patient selection
  • Quality of life
  • Resource allocation

ASJC Scopus subject areas

  • Medicine(all)
  • Transplantation

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