Abstract: FR-PO1118
Personalized Risk Prediction to Support Deceased Donor Kidney Offer Decisions: A Qualitative Study of Transplant Stakeholder Perspectives
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Chong, Kelly, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
- Litvinovich, Igor, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
- Argyropoulos, Christos, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
- Taylor, Rachel, The University of New Mexico, Albuquerque, New Mexico, United States
- Zhu, Yiliang, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Background
Rising kidney discard rates and persistent uncertainties about transplant outcomes in accepting higher risk donor kidneys underscore the need for decision support tools that integrate donor and recipient factors and communicate risk clearly at the time of an offer. Existing tools such as the Kidney Donor Profile Index provide population level signals but do not deliver individualized, cognitively accessible information aligned with real time clinical workflows. We sought stakeholder input on the design and deployment features of a prototype Kidney Risk Calculator to support patient centered transplant decision making.
Methods
We conducted a qualitative study using focus groups and individual interviews with transplant stakeholders at a single transplant center. Participants included transplant candidates and a patient advocate, transplant coordinators, and transplant providers. Semi structured sessions included a live demonstration of the prototype app and explored usability, interpretability, contextual information needs, perceived clinical utility, and anticipated barriers and facilitators. Sessions were recorded, transcribed and analyzed using inductive reflexive thematic analysis.
Results
Stakeholders viewed personalized transplant outcome projections as a helpful adjunct to clinical judgment, particularly for higher risk offers. Key design priorities included: (1) educational content on hepatitis C virus, Public Health Service risk criteria, calculated panel reactive antibody (cPRA), and dialysis versus transplant trade offs; (2) plain language narratives, simple visuals, minimum use of acronyms, U.S. customary measurement units, and stepwise user input flows; and (3) alignment with time pressured, phone based workflows and variable digital access. Stakeholders emphasized clarity, context, and workflow fit alongside predictive accuracy.
Conclusion
Stakeholders highlighted the importance of integrating individualized transplant outcome predictions with accessible, easy to interpret, workflow aligned communication. These findings inform the design and implementation of decision support tools.
Acknowledgment
This study was supported in part by Dialysis Clinic, Inc. (Grant C-4130) and the National Center for Advancing Translational Sciences, National Institutes of Health (UL1TR001449).
Funding
- Commercial Support – Dialysis Clinic, Inc.