*Purpose: Transplant hospitals struggle to meet Organ Procurement and Transplantation Network (OPTN) requirements for LKD follow-up. In the face of barriers such as cost, LKD inconvenience, and the burden of data collection, they lack the tools to improve LKD engagement. To address this critical health system failure, we built the mKidney® System based on input elicited from LKDs, transplant providers, and thought leaders in the field of transplantation.

*Methods: Key features of the mKidney® System include a HIPAA-compliant patient-facing smartphone app and transplant provider-facing web portal, automated short message service (SMS) text messages, email, and push notifications, and data export functionality. We are conducting an ongoing randomized controlled trial (RCT) to evaluate the impact of the mKidney® System on rates of post-donation follow-up, in preparation for a fully-powered multi-site clinical trial (NCT03400085). Participants are randomized to the intervention (mKidney® System) or control arm (standard of care) using block randomization, and follow-up compliance is tracked over time (Figure). Follow-up compliance is ascertained through linkage to national registry data (SRTR).

*Results: To date, our pilot study population includes 237 participants; of whom, 101 have 6-month donor follow-up available from the SRTR registry. Clinical follow-up required for compliance was completed by 46/46 (100%) of participants in the mKidney® arm vs 53/55 (96.4%) of participants in the control arm (Fisher exact p = .5). Required lab follow-up was completed by 45/46 (97.8%) of participants in the mKidney® arm vs 46/55 participants (83.6%) in the control arm (Fisher exact p=0.02).

*Conclusions: Designed specifically to facilitate the collection and reporting of LKD follow-up data, the mKidney® System is a promising new solution to improve historically poor care management for LKDs in the US.

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