Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Deceased donor organ intervention research (“intervention research”) aims to increase organ quality and quantity for transplantation by protecting against organ injury and enhancing functionality. Little is known about transplant candidates’ willingness to accept these “intervention organs.” We present findings from a conjoint analysis involving kidney transplant candidates at two transplant centers or who are members of the American Association of Kidney Patients and the National Kidney Foundation of Illinois.
*Methods: Conjoint analysis is a research methodology that elicits patient preferences by manipulating key elements of a decision — whether to accept a kidney allograft. Candidates reviewed 12 hypothetical scenarios in which we systematically varied donor age, projected waiting time until the patient would get another organ offer, research risk to organ, and research risk to the recipient. With each scenario, the candidate either agreed to accept the intervention organ or remain on the waiting list. Candidates were contacted by phone and/or online.
*Results: A total of 249 candidates were eligible and participated. Participants were mostly female (53.6%), white (56.6%), had a mean age of 54 years, and had been on the waitlist a median of 24 months. Across all hypothetical scenarios, 92 (37.0%) would have accepted all intervention organs, 147 (59.0%) would have accepted intervention organs under some conditions, and 10 (4.0%) would have rejected intervention organs under all conditions. In multivariable logistic regression, factors independently associated with candidates’ greater likelihood of accepting an intervention organ and participating in intervention research included younger donor age (age 30 vs. 60 years) (odds ratio [95% confidence interval]: 3.75 [2.87-4.93]), longer waiting time until the next organ offer (i.e., 4 years vs. 1 year) (3.58 [2.73-4.69]), and when the risk to the kidney from intervention research was low (19.59 [13.34-28.77]) or moderate (2.16 [1.61-2.90]) rather than high; (P<0.0001 for each variable). Candidate characteristics independently associated with accepting an intervention organ included being non-Black (4.90 [1.93-12.45); P<0.001), being on the waitlist for less time (0.97 [0.96-0.99]; P<0.002), and having greater trust in their transplant physician (1.03 [1.00-1.06]; P<0.03).
*Conclusions: Most candidates would accept an intervention organ under most circumstances. High willingness to accept intervention organs underscores the urgent need to overcome regulatory and ethical issues preventing intervention research from being carried out. Transplant programs should become prepared for engaging in informed consent about intervention organs.
To cite this abstract in AMA style:Gordon E, Reese P, Lee J, Krishnamurthi L, Veatch R, Knight R, Conway PT, Dunn S, Abt P. Determinants of Kidney Transplant Candidates’ Willingness to Accept Deceased Donor Organ Intervention Research: A Conjoint Analysis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/determinants-of-kidney-transplant-candidates-willingness-to-accept-deceased-donor-organ-intervention-research-a-conjoint-analysis/. Accessed October 27, 2020.
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