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
StatePublished - Jan 1 2017

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Long-Term Care
Kidney Transplantation
Transplants
Practice Guidelines
Chronic Kidney Failure
Dementia
Assisted Living Facilities
Outcome Assessment (Health Care)
Skilled Nursing Facilities
Group Homes
Postal Service
Intellectual Disability
Social Support
Population
Psychiatry
Consensus
Referral and Consultation
Cross-Sectional Studies
Transplantation
Demography

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)
  • Transplantation

Cite this

Transplant professionals' perceptions of long-term care residents' candidacy for kidney transplantation. / Urbanski, Megan; Browne, Teri; Ghanta, Mythili; Constantinescu, Serban; Gillespie, Avrum; Hammer, Heather; Traino, Heather.

In: Progress in Transplantation, Vol. 27, No. 2, 01.01.2017, p. 146-151.

Research output: Contribution to journalArticle

Urbanski, Megan ; Browne, Teri ; Ghanta, Mythili ; Constantinescu, Serban ; Gillespie, Avrum ; Hammer, Heather ; Traino, Heather. / Transplant professionals' perceptions of long-term care residents' candidacy for kidney transplantation. In: Progress in Transplantation. 2017 ; Vol. 27, No. 2. pp. 146-151.
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