Intro: The accuracy and integrity of very large waiting lists are difficult to maintain over time. We implemented newly available information technology to increase access to patients, improve communication, and expedite patient work-up. A validated^(1-2)web-based software platform (BREEZE TRANSPLANT, MedSleuth, Inc.) automated ongoing monitoring of candidates on the waiting list. Information from this automated system augments routinely collected data, and frequently leads to clinical decision making. We report 6 months of automated monitoring of a portion of our waitlist.

Methods: The automated questionnaire was designed to identify events that might sensitize the patient or trigger a re-evaluation of transplant candidacy, as well as update contact information, clinical parameters (height, weight, BMI), and assess patient interest in donor programs (living donors, high KDPI donors, etc.,). The automated web-based software employs proprietary algorithms to generate an individualized dynamic patient questionnaire. The software interacts via email.

Results: 1,074 patients completed the automated data collection, representing 43.8% of patients the system attempted to interact with thus far. Patients were not formally instructed about the new system prior receiving the email. Data are automatically transmitted to the transplant center in real-time. 7.0% of patients reported a new potential living donor, 48.5% indicated a secondary insurance provider, and 12.8% updated contact information. 45% of patients reported a recent visit to the ER, and 38% were recently admitted to the hospital. 13% received a blood transfusion over the last 12 months. Free-text entry also identified many other sensitizing events and changes in condition that should initiate re-evaluation of candidacy. 14% expressed a new interest in receiving a kidney from a high KDPI donor.

Conclusion: A fully automated interactive web-based portal can successfully interact with patients on the waiting list. This approach improves communication, waitlist management, acceptance of different donor programs, and could be used to initiate testing for HLA antibodies after sensitizing events and re-evaluation of transplant candidacy after changes in health. Implementation of an automated phone call alerting the patient to the upcoming email, and formal education about the automated system are likely to increase completion of questionnaires.

1.) A851, ASA 2011, USA

2.) S104, IARS 2011, Canada.

CITATION INFORMATION: Braun H, Parente M, Hirose R, Roll G. Automated Web-Based Monitoring Identifies Significant Clinical Changes in Patients Awaiting Kidney Transplant. Am J Transplant. 2016;16 (suppl 3).

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