Kidney Week

Abstract: TH-PO731

Variation in Quality of Life in Frail, Older Transplant Recipients: Mixed-Methods Results from the Kidney Transplantation in Older People (KTOP) Study

Session Information

• Transplantation: Clinical - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Thind, Amarpreet Kaur, Imperial College London Faculty of Medicine, London, London, United Kingdom

Amarpreet Kaur Thind, MBBS

• Johansson, Lina, Hammersmith Hospital, London, London, United Kingdom

Lina Johansson, PhD

• Willicombe, Michelle, Imperial College London Faculty of Medicine, London, London, United Kingdom

Michelle Willicombe, MD, MA, MBBS

• Brown, Edwina A., Hammersmith Hospital, London, London, United Kingdom

Edwina A. Brown, MD, MBChB

Group or Team Name

• Kidney Transplantation in Older People Study Investigator Group.

Background

Demand for kidney transplantation (KT) in older people is increasing. Frailty predicts poorer medical outcomes, but little is known about quality of life (QoL) and lived experiences of KT in frail older people.

Methods

KTOP is a 2-year observational study of patients aged >60 years on the KT waitlist. The mixed methods design used questionnaires and semi-structured interviews to explore QoL experiences. Descriptive and mixed-effect analysis was used for the questionnaires and thematic analysis for the interviews. The qualitative data enabled richer understanding of trends identified from questionnaires.

Results

210 patients were recruited. 68 were vulnerable/frail of whom 35 underwent KT. 21 were recruited into the qualitative study, 10 of whom underwent KT.
After KT, vulnerable/frail participants experienced stabilising of physical QoL (figure), with 81.3% reporting improved treatment satisfaction and less illness intrusion (68.8%). However, mental QoL declined (figure) and 58.8% reported worse symptom burden after KT.
Qualitative themes revealed KT as physically and emotionally demanding (table). Time free from dialysis was valued yet challenged by unchanging frailty and unexpected burdens of KT. Family/social networks, spiritual beliefs, and positive mindset enabled coping with KT.

Conclusion

Vulnerable/frail older people have mixed QoL changes after KT. Determining expectations of KT and individual personal and socio-cultural resources, are integral to discussions and decision making around KT listing.