Abstract: TH-PO848
Transition of Care of Stable Kidney Transplant Patients to Referring Nephrologists: A National Survey of US Transplant Centers
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Lentine, Krista L., Saint Louis University, Saint Louis, Missouri, United States
- Singh, Neeraj, Willis-Knighton Health System, Shreveport, Louisiana, United States
- Woodside, Kenneth J., Gift of Life, Ann Arbor, Michigan, United States
- Maher, Kennan Ryan, Willis-Knighton, Shreveport, Louisiana, United States
- Alhamad, Tarek, Washington University in St Louis, St Louis, Missouri, United States
- Bloom, Roy D., University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Dadhania, Darshana M., Cornell University, Ithaca, New York, United States
- Doshi, Mona D., University of Michigan, Ann Arbor, Michigan, United States
- Parsons, Ronald, Emory University, Atlanta, Georgia, United States
- Gupta, Gaurav, Virginia Commonwealth University, Richmond, Virginia, United States
- Waterman, Amy D., Houston Methodist, Houston, Texas, United States
- Tanriover, Bekir, Banner University Medical Center Tucson, Tucson, Arizona, United States
- Singer, Gary G., Midwest Nephrology, St. Louis, Missouri, United States
- Anand, Prince Mohan, Medical University of South Carolina, Charleston, South Carolina, United States
Background
Transition of care from transplant centers (TC) to referring nephrologists is critical for long-term care of kidney transplant (KTx) recipients. We conducted a national survey to assess opinions and experiences of TC staff related to care graduation processes.
Methods
After IRB approval, staff at U.S. adult kidney TC were surveyed using the Qualtrics survey platform (4/5/22–10/31/22). Respondents were invited via email and professional society list-servs. If >1 survey was submitted for a TC, a selection hierarchy was utilized (e.g. prioritizing nephrologists).
Results
Respondents represented 55% of YC (n=108) and 67% of national KTx volume. The majority of respondents (78%) were nephrologists. Full graduation to referring nephrologists was reported by 37% of TC, while 48% reported partial graduation with ongoing co-management. Rationales for graduation included patient travel distance (64%), maintenance of referral base (58%), continuity of care (58%), and TC burden (54%) (Fig. A). Common reasons cited by TC for post-graduation return of care included worsening renal function (80%), malignancy (66%), opportunistic infection (63%), local nephrologist availability (58%), and pregnancy planning (57%) (Fig. B).
Additional staff were cited by 78% of TC as needed to enable TC perpetual care, with 70% expressing need for more clinicians. Nearly 50% thought more physical space or telemedicine are required.
Conclusion
Graduation of KTx patients is common, with half of TC using joint-care. With continued growth of the KTx population, expanded opportunities related to transplant care for the general nephrology community are essential.
Funding
- Private Foundation Support