Abstract: FR-PO1047

Perceptions of Patients with ESRD about Reasons for Transplant Non-Referral and Non-Listing

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Morrow-Sutton, Mary, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Mahmood, Hafiz Zafar Ahmed, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Farooq, Umar, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Ghahramani, Nasrollah, Penn State College of Medicine, Hershey, Pennsylvania, United States
Background

Kidney transplant (KT) is the treatment of choice for most patients with end stage renal disease (ESRD). We explored patients’ understanding of reasons for non-referral for transplant and reasons for not having been placed on the transplant waiting list.

Methods

We sent flyers to 1,283 dialysis units. Of 2536 interested participants who fulfilled inclusion criteria, we randomly selected and invited 1400 to complete a survey which included questions regarding referral, evaluation and listing for KT.

Results

Of 673 participants, 401 had been referred, 361 had been evaluated and 201 were listed for transplant. A total of 272 patients (40%) indicated that they had not been referred for evaluation. The most common reasons cited by patients for not being referred for evaluation included: patient choice (24%), age (10%), weight (10%), and being too sick (9%). In 10% of cases, the patients indicated that their nephrologist had not mentioned KT as an option. The reason for non-referral was unknown to 16% of the patients. Forty patients indicated that they had been referred but never evaluated for listing. Patient choice was the most common cause for not being evaluated (26%), followed by being overweight (10%) and being too sick (8%). The reason for not being evaluated was unknown to 17% of referred patients. Of the patients who had undergone the evaluation process, 160 (44%) were not listed. Patient choice was the most common reason for not pursuing the listing process (33%), being too sick (13%), and being overweight (10%). The reason for not being listed was unknown to 12% of the evaluated patients.

Conclusion

Patient choice is the most commonly cited reason for not being referred, evaluated or listed for KT. A significant proportion of patients are not aware of the reason they have not been referred, evaluated or listed for KT.

Funding

  • NIDDK Support