TY - JOUR
T1 - Transplant professionals' perceptions of long-term care residents' candidacy for kidney transplantation
AU - Urbanski, Megan
AU - Browne, Teri
AU - Ghanta, Mythili
AU - Constantinescu, Serban
AU - Gillespie, Avrum
AU - Hammer, Heather
AU - Traino, Heather
N1 - Publisher Copyright:
© 2017, NATCO.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2017/6
Y1 - 2017/6
N2 - 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.
AB - 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.
KW - Kidney transplantation
KW - Long-term care
KW - Older adults
KW - Patient selection
KW - Quality of life
KW - Resource allocation
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U2 - 10.1177/1526924817699968
DO - 10.1177/1526924817699968
M3 - Article
C2 - 28617165
AN - SCOPUS:85020684511
SN - 1526-9248
VL - 27
SP - 146
EP - 151
JO - Progress in Transplantation
JF - Progress in Transplantation
IS - 2
ER -