Effectiveness of a Mobile Health System on Compliance With 2-Year Living Kidney Donor Follow-Up in the United States

Clin Transplant. 2025 Apr;39(4):e70139. doi: 10.1111/ctr.70139.

Abstract

Background: Organ Procurement and Transplantation Network (OPTN) policy requires 2 years of follow-up for living kidney donors (LKDs); however, many transplant hospitals struggle to meet this requirement. We developed and tested a mobile health (mHealth) system for LKD follow-up in a pilot randomized-controlled trial (RCT).

Methods: LKDs were randomly assigned to either the intervention (mHealth + standard of care) or control arm (standard of care). We assessed OPTN policy-defined completeness and timeliness of 6-month, 1-year, and 2-year follow-ups. Four hundred LKDs were enrolled in the study (June 2018 to February 2021).

Results: At 6-month follow-up, a higher proportion of the intervention arm participants completed composite visits (97.5% vs. 91.5%, p = 0.01). Both arms had similar compliance rates at 1- and 2-year follow-up (92.0% vs. 89.5%, p = 0.49, and 66.5% vs. 65.0%, p = 0.83). Intervention arm participants completed 6-month follow-up 11 days earlier than their counterparts (p = 0.009).

Conclusion: mHealth technologies improved 6-month follow-up, but did not impact 1- and 2-year LKD follow-up in this single-center RCT. Other strategies, such as providing services beyond data collection, may be necessary to improve donor engagement and support LDK's long-term follow-up.

Keywords: living kidney donation; living kidney donor follow‐up; mobile health.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Transplantation*
  • Living Donors* / statistics & numerical data
  • Living Donors* / supply & distribution
  • Male
  • Middle Aged
  • Patient Compliance* / statistics & numerical data
  • Pilot Projects
  • Prognosis
  • Telemedicine*
  • Tissue and Organ Procurement*
  • United States