Evaluating multiple living kidney donor candidates simultaneously is more cost-effective than sequentially

Habbous, Steven; Barnieh, Lianne; Klarenbach, Scott; Manns, Braden; Sarma, Sisira; Begen, Mehmet A.; Litchfield, Kenneth; Lentine, Krista L.; Singh, Sunita; Garg, Amit X.

doi:10.1016/j.kint.2020.06.015

Cited by 7 publications

(8 citation statements)

References 41 publications

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“…Esto puede estar propiciado por haber aplicado los nuevos protocolos de evaluación que recogen criterios menos restrictivos para la donación y que están basados en evidencias más recientes 8-10 . Debido a esta posibilidad de no considerar apta a una persona para la donación, la literatura ya apunta a que es una buena opción la de considerar la evaluación de hasta cuatro cDR a donantes vivos simultáneamente cuan-do se presenten para el mismo receptor 43 , tal y como se ha procedido en el estudio analizado de los 60 cDR para 50 candidatos a receptores. Este abordaje ha demostrado que los costos para el sistema están compensados en relación con los costos de las diálisis y procedimientos evitados para el receptor 43 .…”

Section: Discussionunclassified

“…Debido a esta posibilidad de no considerar apta a una persona para la donación, la literatura ya apunta a que es una buena opción la de considerar la evaluación de hasta cuatro cDR a donantes vivos simultáneamente cuan-do se presenten para el mismo receptor 43 , tal y como se ha procedido en el estudio analizado de los 60 cDR para 50 candidatos a receptores. Este abordaje ha demostrado que los costos para el sistema están compensados en relación con los costos de las diálisis y procedimientos evitados para el receptor 43 . Además, de la misma manera que se ha reportado en los datos presentados, también hay evidencia previa de que el proceso de evaluación puede diagnosticar afecciones médicas en algunos cDR contando que, de otro modo, tal vez no se hubieran reconocido 44 y que algunas de ellas pueden ser no ser malignas y comunes entre la población 45 .…”

Section: Discussionunclassified

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Necesidades asistenciales en el estudio de personas candidatas a donantes de riñón

Robles

Fraile²,

Bach-Pascual

et al. 2022

Enferm Nefrol

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Objetivos: Describir las necesidades asistenciales del candidato a donante de riñón; sus características sociodemográficas y clínicas; y analizar los resultados desde una perspectiva de género.Material y Método: Estudio observacional descriptivo transversal. Se recogieron datos clínicos; sociodemográficos; y el número y tipo de visitas y pruebas realizadas durante el año 2020.Resultados: Se incluyeron 60 candidatos a donantes de riñón (n=37 mujeres; 61,67%) con una media de 51,98±14,50 años y una mediana de 2,5 [RIQ (0,69-5,29)] meses de estudio. 16 (26,67%) fueron aptos para la donación, correspondiendo al 14,16% de la actividad en Trasplante Renal (TR) del centro de referencia. Se requirieron 757 visitas (20,60% de la actividad) de las que 341 (45,05%) fueron visitas con la enfermera. Se requirieron 423 pruebas (19,60% de la actividad) durante el estudio. Se identificó una media de 1,87±1,35 factores de riesgo cardiovascular en la muestra analizada, siendo de 1,56±0,81 en los que finalmente fueron donantes. Más mujeres (n=12; 75%) que hombres (n=4; 25%) fueron finalmente donantes renales.Conclusiones: El estudio del candidato a donante de riñón es complejo e implica el doble de actividad que en el de los candidatos a receptores de trasplante renal. El proceso finaliza en donación en el 27% de los candidatos estudiados. La enfermera concentra el 45% de las visitas que se requieren. Es necesario explorar estrategias para optimizar el proceso de estudio. Hay diferencias de género en cuanto a la predisposición para estudiarse voluntariamente como candidata a donante renal.

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Section: Discussionunclassified

Necesidades asistenciales en el estudio de personas candidatas a donantes de riñón

Robles

Fraile²,

Bach-Pascual

et al. 2022

Enferm Nefrol

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“…These include having experienced staff, automation of the donor intake process, and sensible donor prioritization which included limiting the number of donor evaluations occurring simultaneously. While a number of "manageable simultaneous potential living donor evaluations" was not quoted by survey participants, a recent publication by Habbous et al discussing the cost-effectiveness of concurrent multiple living kidney donor evaluations for the same patient rather than sequentially, noted that that number may be up to four simultaneous potential living donor evaluations [29]. In Habbous' study, limiting the number of evaluations to 4 concurrent ones leads to cost savings per intended recipient (despite the greater aggregate costs of multiple living donor evaluations) and increased living donor kidney transplant by 1% [29].…”

Section: What Can We Learn About Use For Social Media For Living Dono...mentioning

confidence: 99%

“…While a number of "manageable simultaneous potential living donor evaluations" was not quoted by survey participants, a recent publication by Habbous et al discussing the cost-effectiveness of concurrent multiple living kidney donor evaluations for the same patient rather than sequentially, noted that that number may be up to four simultaneous potential living donor evaluations [29]. In Habbous' study, limiting the number of evaluations to 4 concurrent ones leads to cost savings per intended recipient (despite the greater aggregate costs of multiple living donor evaluations) and increased living donor kidney transplant by 1% [29]. Habbous findings may serve as a reference for transplant programs wanting to prioritize potential living donor evaluations for a single recipient.…”

Section: What Can We Learn About Use For Social Media For Living Dono...mentioning

confidence: 99%

Utilizing Social Media to Identify Potential Living Donors: Learning from US Living Donor Programs

Nishio-Lucar

Hunt²,

Booker³

et al. 2022

Curr Transpl Rep

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Purpose of Review Living donor transplantation provides the best possible recipient outcomes in solid organ transplantation. Yet, identifying potential living donors can be a laborious and resource intensive task that heavily relies on the recipient’s means and social network. Social media has evolved to become a key tool in helping to bring recipients and potential living donors together given its ease of utilization, widespread access, and improved recipient’s comfort with public solicitation. However, in the USA, formal guidelines to direct the use of social media in this context are lacking. Recent Findings To better inform the landscape and opportunities utilizing social media in living donation, the OPTN Living Donor Committee surveyed US transplant programs to explore programs’ experiences and challenges when helping patients use social media to identify potential living donors (September 2019). A large majority of survey participants (N = 125/174, 72%) indicated that their program provided education to use social media to identify potential living donors and most programs tracking referral source confirmed an increase utilization over time. The use of social media was compounded with program and recipient’s challenges including concerns about privacy, inadequate technology access, and knowledge gaps. In this review, we discuss the results of this national survey and recent literature, and provide suggestions to inform program practices and guidance provided to patients wishing to use social media to identify potential living donors. Summary Transplant programs should become competent in the use of social media for potential living donor identification to empower patients interested in using this tool. Social media education should be provided to all patients regardless of voiced interest and, when appropriate, revisited at multiple time points. Programs should consider developing a “team of experts” that can provide focused education and support to patients embarking in social media living donor campaigns. Care should be taken to avoid exacerbating disparities in access to living donor transplantation. Effective and timely guidance to patients in the use of social media could enhance the identification of potential living donors.

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“…Further research is also needed to improve the efficiency of donor evaluations and to generate evidence-based standards to address modifiable process delays. 29,30 Dissemination studies are also necessary to assess whether effects persist when programs are scaled and to identify unexpected barriers that may arise with wider implementation.…”

Section: Priorities For Research Innovationmentioning

confidence: 99%

A Roadmap for Innovation to Advance Transplant Access and Outcomes: A Position Statement From the National Kidney Foundation

Lentine

Pastan

Mohan

et al. 2021

American Journal of Kidney Diseases

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Over the past 65 years, kidney transplantation has evolved into the optimal treatment for patients with kidney failure, dramatically reducing suffering through improved survival and quality of life. However, access to transplant is still limited by organ supply, opportunities for transplant are inequitably distributed, and lifelong transplant survival remains elusive. To address these persistent needs, the National Kidney Foundation convened an expert panel to define an agenda for future research. The key priorities identified by the panel center on the needs to develop and evaluate strategies to expand living donation, improve waitlist management and transplant readiness, maximize use of available deceased donor organs, and extend allograft longevity. Strategies targeting the critical goal of decreasing organ discard that warrant research investment include educating patients and clinicians about potential benefits of accepting nonstandard organs, use of novel organ assessment technologies and real-time decision support, and approaches to preserve and resuscitate allografts before implantation. The development of personalized strategies to reduce the burden of lifelong immunosuppression and support "one transplant for life" was also identified as a vital priority. The panel noted the specific goal of improving transplant access and graft survival for children with kidney failure. This ambitious agenda will focus research investment to promote greater equity and efficiency in access to transplantation, and help sustain long-term benefits of the gift of life for more patients in need.As this article reflects the official position of the National Kidney Foundation (NKF) and because it was reviewed and approved by NKF, it was not peer reviewed by AJKD. This article was prepared by a work group comprising the authors and chaired by Dr Krista Lentine. It was reviewed and approved by the NKF Scientific Advisory Board and the NKF Executive Committee.Complete author and article information provided before references.

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Evaluating multiple living kidney donor candidates simultaneously is more cost-effective than sequentially

Cited by 7 publications

References 41 publications

Necesidades asistenciales en el estudio de personas candidatas a donantes de riñón

Necesidades asistenciales en el estudio de personas candidatas a donantes de riñón

Utilizing Social Media to Identify Potential Living Donors: Learning from US Living Donor Programs

A Roadmap for Innovation to Advance Transplant Access and Outcomes: A Position Statement From the National Kidney Foundation

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