The factors that influence transplant candidates' selection of a transplant center for waitlisting are not well understood. Further, the relative weightage of these factors has not been prioritized in the design of the metrics currently used to evaluate and improve transplant center performance. We attempted to enhance our understanding of patient priorities when selecting a transplant center in order to inform patient-oriented transplant center metric development.

We conducted an anonymous electronic survey of 514 National Kidney Foundation patient panel members. Of these, 99 did not complete the full survey resulting in a cohort of 409 respondents. The survey assessed relative importance of the patient experience, practical considerations, transplant center reputation and experience, and waitlist aspects when selecting a transplant center.

The 409 respondents had a mean age of 56±12 years, were predominantly female (61%), White (79%), and had private health insurance (49%). The respondents were highly educated, with 44% having a Bachelor's or Associate's Degree, and 24% having a Master's or Doctoral degree. Of the respondents, 71% had received a kidney transplant, with the remaining 29% having CKD including 60% actively waitlisted. The transplant center characteristic most important to patients regardless of transplant status was waiting time, listed as most important among 40% of pre-transplant and 26% of post-transplant patients. Post-transplant outcomes were of greater importance to those with a transplant (17%) than without a transplant (15%) but it did not exceed the importance of waiting time.

Both pre-transplant and post-transplant patients list waitlist aspects as the most important factor when evaluating a transplant center. In contrast, current transplant center metrics emphasize post-transplant patient and graft survival. Developing novel patient-oriented metrics that align with patient priorities are necessary, and are likely to influence center performance in a manner that leads to improved patient experience.

CITATION INFORMATION: Michelson A., Brennan C., Mattoo A., Kil B., Tsapepas D., Husain S., Mohan S. Patients Prioritize Waitlist Factors over Outcomes When Evaluating Kidney Transplant Centers Am J Transplant. 2017;17 (suppl 3).

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