Non-Directed Kidney Donor Candidate Referral, Care, and Attrition in an Online Portal.
1Division of Transplant Surgery, University of Wisconsin Hospital and Clinics, Madison, WI
2Division of Nephrology, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI
Meeting: 2017 American Transplant Congress
Abstract number: C57
Keywords: Donors, Kidney transplantation, Patient education, Resource utilization, unrelated
Session Information
Session Name: Poster Session C: Disparity in Access and Outcomes for Solid Organ Transplantation
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
When non-directed live kidney donation (NDD) was first described in the early 2000s, a high rate of inquiry per actual donor was noted. Since then, NDD has become widely integrated, and has been central to the growth of paired kidney exchange. Changes to referral process in the intervening decade– ie, impacts of online donor portals[mdash]have not been explored. Systems for care are poorly understood.
We assessed the NDD candidate inquiry process, attrition and staff workload associated with an online NDD portal. A 2004 publication (the most recent report) described 360 NDD inquiries over a +6 year span1. In contrast, 155 people submitted online non-directed donor inquiry forms to our center from January 1, 2016-November 1, 2016. 106 (68.3%) were women; ages ranged from 14-74.
Of the 155, 8 (5.2%) completed in-person evaluations. 2 of these (1.3%) donated; 2 (1.3%) are in process.
53(34.2%) were ruled out without an in-person evaluation: 26(16.8%) had clear medical contraindication; 23(14.8%) were under age 21 (our cut-off) & received education only; 4(2.6%) wanted pay or lived overseas.
46 (29.7%) were referred to other centers: 22(14.2%) had an identified recipient getting care elsewhere; 24(15.5%) lived 200+ miles away & requested closer referral (to facilitate social support throughout the evaluation and hospitalization).
48(31 %) did not complete evaluation, with 25(16.1%) receiving teaching and counseling (often over several contacts), and 23 (14.8%) with no response after inquiry. 5 inquiries from 2013-2015 continued to get teaching into 2016.
NDD is a staff –resource- rich endeavor even using an online portal, with high volume and high rates of inquiry per actual donor. Many inquiries were from the young, the distant, or those early in decision-making. Centers aiming to expand NDD should consider this in a staffing model, anticipate multiple education contacts, & allow for a lengthy decision-making process. A national online NDD portal might improve referral efficiencies and expand education resources.
1. Jacobs CL, Roman D, Garvey C, Matas AJ. Am J Transplant. 2004 Jul; 4(7): 1110-6.
CITATION INFORMATION: Hays R, Schappe K, Kaufman D, Mandelbrot D. Non-Directed Kidney Donor Candidate Referral, Care, and Attrition in an Online Portal. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Hays R, Schappe K, Kaufman D, Mandelbrot D. Non-Directed Kidney Donor Candidate Referral, Care, and Attrition in an Online Portal. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/non-directed-kidney-donor-candidate-referral-care-and-attrition-in-an-online-portal/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress