Abstract: FR-PO0994
Donor Plan Donor Call (DPDC): A Pilot Randomized Trial of a Shared Decision-Making Intervention for Kidney Transplant Candidates
Session Information
- Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Bandi, Satya Sai Sri, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Bagewadi, Shubhangi, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Mateo, Maria B., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- McWilliams, Jordan O, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
- Behnken, Emma M, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Sivly, Angela, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Branda, Megan E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Hargraves, Ian G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Gionfriddo, Michael Ross, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Sagen, Christine, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Schinstock, Carrie A., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Montori, Victor, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Boehmer, Kasey, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Schaffhausen, Cory, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
Background
Thousands of transplantable kidneys are discarded each year, often due to patient concerns about perceived inferiority. These decisions are made under emotional stress and with limited support. The Donor Plan Donor Call (DPDC) tool, delivered during routine care, aims to improve decision-making through education, values clarification, and advanced planning. This pilot trial seeks preliminary evidence of (1) feasibility of trial procedures and (2) effectiveness of DPDC on willingness to accept less-than-ideal donors and shared decision-making.
Methods
This multi-center randomized controlled pilot trial enrolls adult kidney transplant candidates from two sites, randomized 1:1 to usual care or DPDC. Data collection includes demographics, decisional conflict, organ offer knowledge, distress, and willingness to accept increased risk, KDPI >85%, or Hepatitis C-positive donor offers.
Results
To date, 81 of 100 planned participants are enrolled, with full enrollment expected by November 2025. The DPDC intervention is delivered with high fidelity. However, we encountered challenges that must be addressed for future feasibility. Recruitment of non-white participants has been limited, potentially due to exclusion of non-English speakers. Missing baseline data was more common in the control arm but was mitigated using point-of-care assessments. Clinician survey data capture initially lagged but improved after proactive workflow changes.
Conclusion
The pilot trial has met interim recruitment targets. The imbalance in questionnaire completion, mostly in the control group, underscores the benefit of point-of-care data capture and the importance of robust monitoring. Despite challenges, the DPDC intervention was implemented consistently with high fidelity. Ongoing data collection will assess its preliminary effectiveness in supporting shared decision-making and donor acceptance.