Session Date & Time: None. Available on demand.
*Purpose: Time from transplant evaluation to UNOS listing is unaccounted towards wait-list time in pre-dialysis patients and hence longer evaluation to listing times can prolong the transplant candidate’s time on dialysis. In the past, centers have reported a reduction in time to listing by implementing a 1-day center-coordinated pre-transplant workup. However these studies are single center studies that have compared listing times before and after adopting a one day workup approach. Such studies may have limitations due to comparing patients in different eras and may not have accounted for the changes in transplant staff nor changes in minimal listing criteria during the different study periods.
*Methods: 310 patients were evaluated for Kidney transplant candidacy at 2 centers operated under a common university-based hospital from July 1, 2019 to July 1, 2020. Single day centralized work-up was used at one center which coordinated necessary tests needed to fulfill minimum listing criteria (same day echo, stress test, ultrasound, ct scan, PFTs, labs, CXR, EKG). This was compared with the conventional evaluation center (same-day labs, CXR, EKG with remaining tests individually scheduled after the initial visit). Staff resources at both centers were the same (Transplant surgeons, physicians, coordinators). Time from referral to UNOS listing and evaluation to UNOS listing were compared between the two groups.
*Results: Of the 310 patients analyzed, 72 underwent 1-day center-coordinated evaluation and 238 underwent conventional evaluation. 27 patients at 1 day center and 87 patients at conventional center were deemed not candidate for transplant and were excluded from the study. The median time from referral to evaluation was slightly higher in the 1-day center, 77days vs 69 days in conventional center. The median time from evaluation to being presented at selection meeting was slightly higher in the conventional center group (125 days vs 121 days). The 1-day center had a slightly lower median time from evaluation to UNOS listing (154 days vs 165 days).
*Conclusions: We did not find a significant decrease in time to listing for kidney transplant in spite of incorporating a 1-day center-coordinated pre-transplant workup. We believe that prioritizing staff resources is paramount to optimizing the advantages of a single day centralized pre-transplant kidney workup. Channeling selected patients (pre-dialysis, recipients with potential living donors, high pra, or many years of dialysis behind them) who might benefit from a decreased time to waitlist into a 1-day pretransplant workup center may make more meaningful resource utilization.
To cite this abstract in AMA style:Vijay A, Langford N, Atiemo K, Giusti S, Killackey M, Paramesh A, Jeon H. Single Day Centralized Approach in Kidney Transplant Workup – Lessons Learned from 2 Centers [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/single-day-centralized-approach-in-kidney-transplant-workup-lessons-learned-from-2-centers/. Accessed June 13, 2021.
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