Abstract: TH-PO849
Transition of Care of Successful Kidney Transplant Patients from the Transplant Center: A National Survey of Referring Nephrologists
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Lentine, Krista L., Saint Louis University, Saint Louis, Missouri, United States
- Anand, Prince Mohan, Medical University of South Carolina, Charleston, South Carolina, United States
- Woodside, Kenneth J., Gift of Life, Ann Arbor, Michigan, United States
- Bloom, Roy D., University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Singh, Neeraj, Willis-Knighton Health System, Shreveport, Louisiana, United States
- Alhamad, Tarek, Washington University in St Louis, St Louis, Missouri, United States
- Cooper, Matthew, Froedtert Hospital, Milwaukee, Wisconsin, United States
- Dadhania, Darshana M., Cornell University, Ithaca, New York, United States
- Doshi, Mona D., University of Michigan, Ann Arbor, Michigan, United States
- Gupta, Gaurav, Virginia Commonwealth University, Richmond, Virginia, United States
- Parsons, Ronald, Emory University, Atlanta, Georgia, United States
- Tanriover, Bekir, Banner University Medical Center Tucson, Tucson, Arizona, United States
- Waterman, Amy D., Houston Methodist, Houston, Texas, United States
- Singer, Gary G., Midwest Nephrology Associates, St. Louis, Missouri, United States
Background
We conducted a national survey of nephrologists to assess opinions and experiences related to the process of returning kidney transplant (KTx) patients from the transplant center ("graduating") to referring nephrologist care.
Methods
After IRB and Renal Physicians of America (RPA) approval, RPA members were surveyed using the Qualtrics electronic survey platform during October, 2022.
Results
The majority of the 105 respondents self-identified as private practice general nephrologists (78%). While 40% of respondent practices were within 10 miles of a transplant center (TC), >30% were more than 50 miles from a TC (Fig. A). Post-graduation visits were most frequently reported as every 3 mos. (51%) or every 6 mos. (29%), with lab draw intervals more frequent (monthly 32%, every 2 mos. 11%, and every 3 mos. 33%). Practices that did not accept patients back when ready for graduation (n=15) most typically cited the inability to work closely with the TC (67%) or inadequate staffing/resources for immunosuppression monitoring (53%); time commitment (40%) and patient complexity (33%) were less frequent concerns. Clinicians reported referring KTx recipients back to TC for management after graft dysfunction (79%), cancer (51%), pregnancy planning (41%), or fever (21%) (Fig. B).
Conclusion
Despite many general nephrologists being relatively close to a TC, most care for KTx patients. As expected, allograft dysfunction often leads to referral back to the TC after graduation. Nephrologists who do not accept KTx patients have concerns about communication with the TC or lack of office resources--both of which TC can actively help develop.
Funding
- Private Foundation Support