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Establishing a transplant coordinator-led living kidney donor follow-up clinic
Jennifer A Lumsdaine1, Stephen J Wigmore, Donna Wooton
1Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
Insights
A transplant coordinator-led clinic offers acceptable lifelong care for living kidney donors, with most donors preferring this model for continuity. Further research is needed to understand why some donors miss appointments.
Area of Science:
- Nephrology
- Transplant Surgery
- Healthcare Management
Background:
- Living kidney donation carries low but significant long-term risks of renal failure and hypertension for individuals.
- Establishing effective long-term follow-up care is crucial for living kidney donor well-being.
Purpose of the Study:
- To evaluate the effectiveness and patient acceptance of a living donor follow-up clinic managed by a transplant coordinator.
- To assess the health status of living kidney donors through annual reviews.
Main Methods:
- Annual reviews conducted by a registered nurse transplant coordinator.
- Health assessments included 24-hour urine collection, blood pressure, blood chemistry, urinalysis, and general health status evaluation.
- Referrals to specialists or family practitioners for identified medical issues.
Main Results:
- 20% of donors did not attend scheduled appointments; reasons require further investigation.
- All attending donors had acceptable renal function; 8 were hypertensive and 3 had elevated blood glucose, all referred.
- 81% of donors were satisfied with the follow-up, and 100% found it adequate, with 70% preferring coordinator-led care.
Conclusions:
- A transplant coordinator-led clinic model demonstrates high patient acceptance and provides effective follow-up care for living kidney donors.
- Continuity of care with a known transplant team member may contribute to patient satisfaction.
- Addressing donor non-attendance is essential for optimizing lifelong care strategies.
Background:
The long-term risks of renal failure and hypertension are statistically low for living kidney donors as a group, but can have serious consequences for the individual.
Objectives:
To describe the experience with a transplant coordinator-led living donor follow-up clinic.
Method:
Living kidney donors are reviewed on an annual basis by a designated coordinator (registered nurse). A 24-hour urine collection estimates renal function. Blood pressure and blood chemistry are measured and urinalysis performed. Current health status and wound discomfort are assessed. Any medical problems identified are referred to a specialist hospital department or to the donor's family practitioner.
Results:
Fifty-nine appointments were booked and 12 (20%) donors did not attend. Renal function was within acceptable limits for all attending donors. Three donors had raised blood glucose levels and 8 donors were hypertensive; all were referred to family practitioners. Forty-seven donors (35 new, 12 return) completed a questionnaire on the follow-up provided. Thirty-eight (81%) were satisfied with the follow-up, and 47 (100%) agreed this clinic provided adequate follow-up. Thirty-three (70%) donors stated they preferred that the transplant coordinator performed the follow-up, 3 (6%) preferred the family practitioner, and 11 (23%) had no preference.
Conclusions:
There are many possible solutions to the provision of lifelong care of living kidney donors. The model of a transplant coordinator-led clinic appears to have a high degree of patient acceptance, perhaps because of the continuity of care provided by a known member of the transplant team. Further work is required to identify reasons for nonattendance.
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01:26Kidney Transplant II: Surgical Procedure
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