Abstract: SA-PO1088
Identifying Barriers and Quality Improvement Opportunities to Increase Early Transplant Education and Pursuit Among Patients with CKD at Kaiser Permanente Southern California
Session Information
- Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Waterman, Amy D., Houston Methodist Academic Institute, Houston, Texas, United States
- Rutkowski, Mark P., Kaiser Permanente Southern California, Pasadena, California, United States
- Yi, David K., Kaiser Permanente Southern California, Pasadena, California, United States
- Cannizzaro, Nancy, Kaiser Permanente Southern California, Pasadena, California, United States
- Pulicken, Catherine, Houston Methodist Academic Institute, Houston, Texas, United States
- Mittman, Brian S., Kaiser Permanente Southern California, Pasadena, California, United States
Background
To ensure transplant education and referral for CKD stage 3b–5 patients, stage-specific care pathways must be developed outside transplant centers. In preparation for a multilevel intervention trial, we conducted stakeholder interviews, defined early transplant metrics, and gathered benchmarking data on transplant actions by CKD stage.
Methods
We interviewed renal coordinators and nephrologists to identify multilevel transplant barriers. Using electronic health record data, we identified CKD 3b–5 and ESKD patients at Kaiser Permanent Southern California (KPSC) as of 12/31/2024 who were waitlisted, eligible, or likely to become eligible within 2 years and determined whether they had completed six transplant-related actions.
Results
Of 3,662 CKD 3b–5 and ESKD patients at 13 KPSC sites, 2,868 were currently eligible for waitlisting, yet only 29% were wait-listed (Figure). Barriers included late transplant education, lack of early transplant metric dashboards, site variation, and limited involvement of families or donors. Providers cited hesitancy to discuss transplant early and confusion over eligibility; patients and families reported limited knowledge and resources. Among non–wait-listed patients, 45% had begun the internal work-up, and only 9% were undergoing transplant center evaluation. While 81% of wait-listed patients had attended a modalities class, just 45–61% of others had done so.
Conclusion
Benchmarking at KPSC revealed low waitlisting rates and inconsistent early transplant education for eligible patients. Planned care pathways will address barriers and guide actions by risk group to improve outcomes.
Funding
- Other U.S. Government Support