Background: Current web-based educational approaches about living kidney donation (LKD) are complex, lengthy, and/or text-laden, which may impair accurate interpretation of information, thereby limiting kidney transplant access.Purpose: This paper describes the process of developing animation-based LKD education designed to be suitable for and acceptable to kidney transplant candidates and their support networks.Methods: Based on formative work, early animation prototypes were designed by a transplant surgeon and a health communication expert. In qualitative focus groups and individual interviews, animation prototypes were shown to 46 kidney transplant recipients, 28 kidney transplant candidates, 32 previous or potential kidney donors, 10 caregivers, 32 transplant providers, 24 dialysis providers, and 4 cultural and community advisors for their input regarding animation suitability, acceptability, and potential usability/feasibility. Viewer feedback was used to iteratively refine the animations.Animation design to facilitate adult learning was guided by elaboration theory, Bandura's self-efficacy theory, and Mayer's cognitive theory of multimedia learning.Results: KidneyTIME currently consists of 12 animations about LKD process, benefits, and risks. Conclusions:Patients/friends/family members, experts, and stakeholders provided valuable feedback to the research team that was integrated into the development of KidneyTIME with the goal of enhancing suitability, acceptability, engagement, usability, and feasibility of dissemination.

Background Increasing living‐donor kidney transplantation (LDKT) requires education of transplant candidates and their social network. This pre‐post study tested the feasibility and acceptability of KidneyTIME, an intervention which leverages LDKT video‐based educational content designed for sharing. Methods Adult kidney candidates undergoing transplant evaluation/re‐evaluation and their caregivers at a single transplant center viewed different sets of KidneyTIME videos prior to evaluation. Change in LDKT knowledge, self‐efficacy, and concerns was assessed before and immediately after exposure and 3 weeks later. Also assessed were post‐exposure program feedback, online use, and living donor (LD) inquiry. Results A total of 82 candidates and 79 caregivers participated. Viewers of KidneyTIME demonstrated increases in mean LDKT knowledge by +71% and communication self‐efficacy by +48%, and reductions in concerns by ‐21%. The intervention was received positively, with over 95% of participants agreeing that the videos were understandable, credible, and engaging. By 3 weeks follow‐up, 58% had viewed it again, 63% of family clusters had shared it, and 100% would recommend the program to a friend. Time to LD inquiry was similar to historic controls. Conclusion KidneyTime improved facilitators of LDKT, was rated as highly acceptable, and was highly shared, but did not impact LD inquiry during the COVID‐19 pandemic.

BackgroundThere is no mechanism that matches hard-to-place kidneys with the most appropriate candidate. Thus, unwanted kidney offers are typically to recipients with long renal replacement time (vintage) which is a strong risk factor for mortality and graft failure, and in combination with prolonged cold ischemia time (CIT), may promote interactive effects on outcomes.MethodsConsecutive adult isolated kidney transplants between October 2015 and December 2017 were stratified by vintage younger than 1 year and CIT longer than 30 hours.ResultsLong (n = 169) relative to short (n = 93) vintage recipients were significantly more likely to be younger (32.2 years vs 56.9 years, P = 0.02), black race (40.8% vs 18.3%, P = 0.02), have higher estimated posttransplant survival (52.6 vs 42.0, P = 0.04), and have a comorbid condition (45.6% vs 30.1%, P = 0.02); they were less likely to receive a donation after circulatory death kidney (27.8% vs 39.8%, P = 0.05). Long vintage was significantly associated with length of stay longer than 4 days (45.5% vs 30.1%, P = 0.02), and 30-day readmission (37.3% vs 22.6%, P = 0.02) but not additional operations (17.8% vs 15.1%, P = 0.58), short-term patient mortality (3.0% vs 2.2%, P = 0.70), or overall graft survival (P = 0.23). On multivariate logistic regression, long vintage remained an independent risk factor for 30-day readmission (adjusted odds ratio, 1.92; 95% confidence interval, 1.06-3.47); however, there was no interaction of vintage and CIT for this outcome (P = 0.84).ConclusionsReadmission is significantly associated with pretransplant dialysis duration; however, CIT is not a modifying factor for this outcome.

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