Education Strategies in Dialysis Centers Associated With Increased Transplant Wait-listing Rates

Transplantation. 2020 Feb;104(2):335-342. doi: 10.1097/TP.0000000000002781.


Background: Transplant education in dialysis centers can increase access to kidney transplant; however, dialysis center transplant barriers are common, and limited research identifies the most effective transplant education approaches.

Methods: We surveyed transplant educators in 1694 US dialysis centers about their transplant knowledge, use of 12 education practices, and 8 identified education barriers. Transplant wait-listing rates were calculated using US Renal Data System data.

Results: Fifty-two percent of educators orally recommended transplant to patients, 31% had in-center transplant discussions with patients, 17% distributed print educational resources, and 3% used intensive education approaches. Distribution of print education (incident rate ratio: and using >1 intensive education practice ( within dialysis centers were associated with increased wait-listing rates. Several dialysis center characteristics were associated with reduced odds of using education strategies leading to increased wait-listing. Centers with greater percentages of uninsured patients (odds ratio [OR]: 0.960.970.99), in rural locations (OR: 0.660.790.95), with for-profit ownership (OR: 0.640.770.91), and with more patients older than 65 years (OR: had lower odds of recommending transplant, while centers with a higher patient-to-staff ratio were more likely to do so (OR: Language barriers (OR: 0.480.640.86) and having competing work priorities (OR: 0.400.530.70) reduced the odds of distributing print education. Providers with greater transplant knowledge were more likely to use >1 intensive educational strategy (OR: while providers who reported competing work priorities (OR: 0.510.660.84) and poor communication with transplant centers (OR: 0.580.760.98) were less likely to do so.

Conclusions: Educators should prioritize transplant education strategies shown to be associated with increasing wait-listing rates.

Publication types

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

MeSH terms

  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / trends*
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Renal Dialysis*
  • Surveys and Questionnaires
  • United States
  • Waiting Lists*