Transplant Knowledge vs. Readiness Abstract
2016 CST-CNTRP-SQT Joint Scientific Meeting Abstract Submission
Abstract Organization: CST
Abstract Type: Adult
Science Type: Clinical
Abstract Category: Kidney-Pancreas
Trainee: Yes, Shen Cao1; Supervisor: Dr. Istvan Mucsi, firstname.lastname@example.org
Title: Is transplant knowledge associated with readiness to pursue kidney transplant? A pilot study.
Co-authors and Co-Author Affiliations:
Shen Cao1, Aarushi Bansal1,2, Ke Fan Bei1, Eszter C. Mucsi1, Luca Ugenti1, Eleanor Warsmann1,2 , Amy D. Waterman4, Marta Novak5, Istvan Mucsi1,2,3
- University of Toronto
- Multi-Organ Transplant Program, University Health Network, Toronto, Canada
- Division of Nephrology, University Health Network, Toronto, Canada
- University of California at Los Angeles, Los Angeles, CA, USA
- Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Canada
Living donor kidney transplant (LDKT) offers improved life expectancy and better quality of life compared to deceased donor kidney transplant (DDKT) or dialysis. Transplant knowledge, a modifiable patient characteristic, may influence decision towards LDKT. We explored the relationship between transplant knowledge and readiness to consider DDKT and LDKT among patients with end stage kidney disease (ESKD).
From September 2015 to April 2016, a pilot cross-sectional study of patients with ESKD was conducted. Using Transplant Decision Making Survey, transplant knowledge was assessed with a 19-item true/false and multiple-choice scale. The scores were dichotomized as “low” (below 75th percentile) or “high” (above 75th percentile). DDKT and LDKT readiness were categorized into two groups consistent with the Transtheoretical Model of Behavioral Change: early (precontemplation and contemplation) and late stages (preparation and action). Patients were also asked whether they thought they had a potential living donor (yes/no). Independent association between transplant knowledge and readiness as well as having potential donors identified was analyzed using logistic regression.
A sample of 58 patients receiving pre-dialysis care (n=2), in-centre (n=53), and home dialysis (n=3) were recruited. The sample had a mean (±SD) age of 57 (±15) years, 36 (62%) were male, 26 (49%) Caucasian. We observed a trend between low transplant knowledge and less readiness for LDKT (41% versus 67%, P=0.095) and a numerical difference for DDKT (47% versus 62%, P=0.378). Patients with low transplant knowledge tended to be less likely to have identified a potential living donor (31% versus 57%, P=0.087). The transplant knowledge score was associated with LDKT readiness after adjustment for age, gender, ethnicity and education (OR=1.27, 95% CI=1.00–1.63; P=0.053).
Patients with higher transplant knowledge exhibited a trend towards greater readiness for LDKT and DDKT. These preliminary results suggest that effective educational interventions might improve access to kidney transplants.