Consensus Conference on Best Practices in Live Kidney Donation: Recommendations to Optimize Education, Access, and Care

Rudow, Dianne LaPointe; Hays, Rebecca; Baliga, Prabhakar K.; Cohen, David J.; Cooper, Matthew; Danovitch, Gabriel M.; Dew, Mary Amanda; Gordon, Elisa J.; Mandelbrot, Didier A.; McGuire, Suzanne; Milton, Jennifer; Moore, Derek E.; Morgievich, M.; Schold, Jesse D.; Segev, Dorry L.; Serur, David; Steiner, Robert W.; Tan, Jane C.; Waterman, Amy D.; Zavala, Edward Y.; Rodrigue, James R.

doi:10.1111/ajt.13173

Cited by 172 publications

(178 citation statements)

References 43 publications

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“…A recent consensus conference (20) identifying best practices for increasing LDKT rates formally recommended that outreach and education by community nephrologists, dialysis centers, and nonprofit organizations occur and be repeated regularly to ensure that all patients know about their DDKT and LDKT options. Research confirms that kidney patients who begin transplant evaluation having received more comprehensive education from community nephrologists or within dialysis centers are more likely to complete transplant evaluation successfully (5), get on the transplant waiting list (21), and receive LDKTs (7,22).…”

Section: Discussionmentioning

confidence: 99%

“…Further clarification of the policies about what dialysis centers must do to ensure compliance with CMS requirements regarding transplant education would help translate compliance to delivery of meaningful education. A clear definition of comprehensive and satisfactory patient education about the benefits and risks of this treatment option within dialysis centers is needed (20).…”

Section: Discussionmentioning

confidence: 99%

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Assessing Transplant Education Practices in Dialysis Centers

Waterman

Peipert

Goalby

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives The Centers for Medicare & Medicaid Services (CMS) requires that dialysis centers inform new patients of their transplant options and document compliance using the CMS-2728 Medical Evidence Form (Form-2728). This study compared reports of transplant education for new dialysis patients reported to CMS with descriptions from transplant educators (predominantly dialysis nurses and social workers) of their centers' quantity of and specific educational practices. The goal was to determine what specific transplant education occurred and whether provision of transplant education was associated with center-level variation in transplant wait-listing rates.Design, setting, participants, & measurements Form-2728 data were drawn for 1558 incident dialysis patients at 170 centers in the Heartland Kidney Network (Iowa, Kansas, Missouri, and Nebraska) in 2009-2011; educators at these centers completed a survey describing their transplant educational practices. Educators' own survey responses were compared with Form-2728 reports for patients at each corresponding center. The association of quantity of transplant education practices used with wait-listing rates across dialysis centers was examined using multivariable negative binomial regression.Results According to Form-2728, 77% of patients (n=1203) were informed of their transplant options within 45 days. Educators, who reported low levels of transplant knowledge themselves (six of 12 questions answered correctly), most commonly reported giving oral recommendations to begin transplant evaluation (988 informed patients educated, 81% of centers) and referrals to external transplant education programs (959 informed patients educated, 81% of centers). Only 18% reported having detailed discussions about transplant with their patients. Compared with others, centers that used more than three educational activities (incident rate ratio, 1.36; 95% confidence interval, 1.07 to 1.73) had higher transplant wait-listing rates.Conclusions While most educators inform new patients that transplant is an option, dialysis centers with higher wait-listing rates use multiple transplant education strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessing Transplant Education Practices in Dialysis Centers

Waterman

Peipert

Goalby

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…The Live Donor Community of Practice within the American Society of Transplantation, with the financial support of 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014 (10). The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD.…”

Section: Introductionmentioning

confidence: 99%

Living Donor Kidney Transplantation

Rodrigue

Kazley

Mandelbrot

et al. 2015

Clinical Journal of the American Society of Nephrology

108

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Despite its superior outcomes relative to chronic dialysis and deceased donor kidney transplantation, live donor kidney transplantation (LDKT) is less likely to occur in minorities, older adults, and poor patients than in those who are white, younger, and have higher household income. In addition, there is considerable geographic variability in LDKT rates. Concomitantly, in recent years, the rate of living kidney donation (LKD) has stopped increasing and is declining, after decades of consistent growth. Particularly noteworthy is the decline in LKD among black, younger, male, and lower-income adults. The Live Donor Community of Practice within the American Society of Transplantation, with financial support from 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014. The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD. In this article, we discuss trends in LDKT/LKD and emerging novel strategies for attenuating disparities, and we offer specific recommendations for future clinical practice, education, research, and policy from the Consensus Conference Workgroup focused on disparities.

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“…The development of the meeting and workgroups, rationale for the topics, process of creating consensus, and top recommendations are outlined in more detail in an overview meeting report (3). Recommendations included strategies to educate patients with CKD and ESRD, potential living donors, and the public; efficiencies in processes; policy initiatives; and a research agenda.…”

mentioning

confidence: 99%