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  1. Home
  3. The Use Of Kidneys With Lower Longevity From Deceased Donors To Improve Access To Preemptive Renal Transplantation For Elderly Patients: A Qualitative Study.
  1. Home
  3. The Use Of Kidneys With Lower Longevity From Deceased Donors To Improve Access To Preemptive Renal Transplantation For Elderly Patients: A Qualitative Study.

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The Use of Kidneys With Lower Longevity From Deceased Donors to Improve Access to Preemptive Renal Transplantation

Carina Sancho1, Aliya Affdal1,2, Fabián-Andrés Ballesteros Gallego2

  • 1Bioethics Program, École de santé publique de l'Université de Montréal, Québec, Canada.

Canadian Journal of Kidney Health and Disease
|August 2, 2024

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
elderly patientsethicsnonutilized kidneyspreemptive transplantationqualitative interviews

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Elderly patients support using lower longevity kidneys for preemptive transplantation to improve quality of life and avoid dialysis. Patient involvement and a separate waitlist are crucial for this kidney transplant option.

Area of Science:

  • Nephrology
  • Transplantation immunology
  • Patient-centered care

Background:

  • Significant gap exists between kidney transplant demand and donor organ supply.
  • Some deceased donor kidneys are underutilized due to concerns about suboptimal graft survival.
  • Utilizing lower longevity kidneys for preemptive transplantation in elderly candidates could be a viable therapeutic option.

Purpose of the Study:

  • To explore elderly patients' perspectives on allocating kidneys with reduced longevity for preemptive kidney transplantation.
  • To understand patient preferences regarding informed consent and decision-making in this context.

Main Methods:

  • Conducted 14 individual interviews with patients aged 64-75 with advanced chronic kidney disease (CKD G4-5 ND) not yet on dialysis.
  • Interviews were digitally recorded, transcribed, and analyzed using thematic analysis.
  • Study setting was a single chronic kidney disease clinic at the Centre hospitalier de l'Université de Montréal (CHUM).

    • Main Results:

    • Most participants favored using lower longevity kidneys to increase transplant access, enhance quality of life, and avoid dialysis.
    • Patients emphasized the importance of engagement in the decision-making process and informed consent.
    • Concerns included reduced graft survival and the need for re-transplantation, with interest in mitigation strategies and a separate waitlist.

    Conclusions:

    • Preemptive kidney transplantation using lower longevity deceased donor kidneys is a promising option for elderly candidates.
    • Essential elements include comprehensive patient information, active participation in decision-making, and potentially a dedicated waitlist.
    • Organ donation organizations and transplant programs should consider developing specific protocols and waitlists for this patient group.