Abstract: TH-PO938
Comprehensive Geriatric Assessment (CGA) and Optimisation Services before Kidney Transplantation in Older Potential Recipients: Results from the First UK-Wide Transplant Centre Survey Study
Session Information
- Geriatric Nephrology: Innovations and Insights
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1300 Geriatric Nephrology
Authors
- Holland, John, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
- Partridge, Judith SL, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
- Cronin, Antonia, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
Background
In the UK,as elsewhere,chronic kidney disease (CKD) is more prevalent in older people.Kidney transplant is the treatment of choice for End-Stage-Kidney Disease (ESKD).As the number of patients aged over 60 with advanced CKD increases,the demand for transplants in this cohort will inevitably increase.Frailty, multimorbidity and cognitive impairment are seen frequently in old age and are associated with poorer transplant outcomes.CGA is a multidimensional multidisciplinary methodology that has demonstrated benefit at systematic review level in modifying outcomes relating to these factors.This national survey aims to describe availability of CGA and optimisation services across the UK, assess attitudes and beliefs on CGA among transplant clinicians and investigate practice relating to assessment and documentation of mental capacity prior to transplant listing.
Methods
A 21-question electronic survey was developed on the SurveyMonkey platform using established healthcare survey methodology including focus groups,piloting,and research-specific question design.Lead transplant clinicians at each of the UK’s 23 transplant centres were contacted by email and invited to participate using a protected survey link between 24/04/24-15/05/24
Results
A 100% response rate was obtained (23/23).Most respondents reported that frailty (13/19) and cognitive impairment (9/18) in potential transplant recipients over 60 were not adequately addressed by current NHS services.17/19 (89%) of respondents were in favour of using CGA in this population though only 3 units offered CGA.Lack of funding (13/18) and clinical evidence (12/18) were reported as key barriers to implementing CGA services.Most respondents reported their unit lacked robust methods of assessing (10/18) and documenting (10/18) mental capacity of potential transplant recipients prior to listing.
Conclusion
Our nationwide survey shows that at present frailty, multimorbidity and cognitive impairment in older potential kidney transplant recipients are not being adequately addressed in the UK.An overwhelming majority of respondents were in favour of making CGA accessible to this group.Research is underway to develop a transplant-specific CGA to improve access to and outcomes from kidney transplant in this patient cohort.