Living donor kidney transplantation (LDKT) is the optimal treatment for end-stage kidney disease (ESKD). But, the evaluation process for a kidney transplant is complex, time consuming, and burdensome to the ESKD patient. Also, race disparities exist in rates of transplant evaluation completion, transplantation, and LDKT. Our previous NIDDK-funded research indicated that cultural factors (i.e., perceived discrimination in healthcare, religious objection to LDKT), transplant knowledge, and demographic characteristics (e.g., age, education, income) independently and significantly predicted time to complete transplant evaluation. In December 2012, our transplant center implemented a streamlined, one-day evaluation process, dubbed Kidney Transplant Fast Track (KTFT). This presentation describes the protocol of a two-part study to evaluate the effectiveness of KTFT (n=1030) at increasing transplant rates (compared to historical controls, n=1140, from our previous NIDDK study) and the educational components of the TALK intervention (Talking About Live Kidney Donation) at increasing LDKT during KTFT. All participants will receive the KTFT evaluation as part of their usual care, and will be randomly assigned to TALK (n=515) versus no-TALK (n=515) conditions. Participants will undergo interviews at pre-transplant work-up and transplant evaluation. Transplant status will be tracked via medical records. Our aims are to: (1) test the efficacy and cost effectiveness of the KTFT in reducing time to complete kidney transplant evaluation, and increasing kidney transplant rates relative to standard evaluation practices; (2) test whether TALK increases rates of LDKT during KTFT; and (3) determine whether engaging in a streamlined and coordinated-care evaluation experience within the transplant center reduces negative perceptions of the healthcare system. The results of this two-pronged approach will help pave the way for other transplant centers to implement a fast-track system at their sites, improve quality of care by transplanting a larger number of vulnerable patients, and address stark race/ethnic disparities in rates of LDKT.

CITATION INFORMATION: Bornemann K, Croswell E, Abaye M, Bryce C, Chang J, Good D, Freehling Heiles C, Dew M, Boulware L, Tevar A, Myaskovsky L. Protocol of the KTFT-TALK Study to Reduce Racial Disparities in Kidney Transplant Evaluation and Living Donor Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress