Patients Prioritize Waitlist Over Posttransplant Outcomes When Evaluating Kidney Transplant Centers

Am J Transplant. 2018 Nov;18(11):2781-2790. doi: 10.1111/ajt.14985. Epub 2018 Jul 30.

Abstract

Factors that patients value when choosing a transplant center have not been well studied. In order to guide the improvement of patient-facing materials, we conducted an anonymous electronic survey of patients that assessed the relative importance of patient experience, practical considerations, transplant center reputation, center experience, and waitlist when selecting a transplant center. A total of 409 respondents completed the survey, of whom 68% were kidney transplant recipients and 32% had chronic kidney disease or were on dialysis. Participants had mean age 56 ± 12 years and were predominantly female (61%), white (79%), and had an associate's degree or higher (68%). Participants most often prioritized waitlist when evaluating transplant centers (transplanted 26%, chronic kidney disease 40%), and waitlist was almost twice as likely as outcomes to be ranked most important (30% vs 17%). Education level and transplant status were significantly associated with factors used for center prioritization. Waitlisted respondents most commonly (48%) relied on physicians for information when selecting a center, while a minority cited transplant-specific organizations. In order to improve shared decision-making, materials outlining center-specific waitlist features should be prioritized. Novel patient-oriented metrics for measuring transplant center quality that align with patient priorities must be explored.

Keywords: Scientific Registry for Transplant Recipients (SRTR); clinical research/practice; health services and outcomes research; kidney transplantation/nephrology; organ procurement organization; patient characteristics; quality of care/care delivery; social sciences.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Graft Rejection / psychology*
  • Graft Survival
  • Humans
  • Kidney Transplantation / mortality*
  • Kidney Transplantation / psychology*
  • Male
  • Middle Aged
  • Patient Preference*
  • Postoperative Complications / psychology*
  • Prognosis
  • Renal Dialysis
  • Survival Rate
  • Transplant Recipients / psychology*
  • Waiting Lists / mortality*
  • Young Adult