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Abstract: PO2520

Variations in Practice Patterns in Eligibility Assessments Across Kidney Transplant Programs in the United States

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Whelan, Adrian, University of California San Francisco, San Francisco, California, United States
  • Lee, Brian K., University of California San Francisco, San Francisco, California, United States
  • Adey, Deborah B., University of California San Francisco, San Francisco, California, United States
  • Nallapothula, Dhiraj, University of California San Francisco, San Francisco, California, United States
  • Ku, Elaine, University of California San Francisco, San Francisco, California, United States
Background

Kidney transplant programs are known to vary in terms of their practice patterns given lack of consensus surrounding many aspects of pre-transplant workup. The differences in national practice patterns related to transplant eligibility assessments have not been well described in the contemporary era.

Methods

We conducted a survey of kidney transplant programs in the US to assess current practice patterns as it relates to criteria for prioritizing transplant referrals, candidate evaluation, and determination of eligibility for kidney transplantation. We distributed our survey to 171 adult kidney transplant programs in the US.

Results

89 (52%) of programs invited to participate in the survey completed it, 45% of which were completed by the Medical Director, 48% by a Transplant Nephrologist, and 7% by other providers. The majority of programs (58%) screened referrals for contraindications to transplantation before scheduling an in-person evaluation (Figure 1). 52% of programs did not prioritize the evaluation of patients with a self-identified living donor candidate when scheduling patients referred for eligibility assessments (Figure 1). Centers differed in the kidney function threshold at which transplant evaluation was begun, and age and body mass index limits for transplantation also varied considerably (Figure 1).

Conclusion

There is wide variation across transplant programs in the assessment of eligibility for kidney transplantation. Further studies are needed to understand how these variations may be associated with access to transplantation and post-transplantation outcomes.

Funding

  • NIDDK Support