Increasing Access to Living Donor Kidney Transplantation: A Program Report

The best treatment option for most patients with kidney failure is a transplant from a living kidney donor, yet multiple barriers prevent most patients from receiving one. The Living Donor Kidney Transplantation project within the Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network aims to improve access to living donor kidney transplantation across Ontario and beyond by enhancing our understanding of the living kidney donor and kidney transplant processes and by implementing and evaluating patient-informed, evidence-based solutions.

To achieve our goal of improving access to living donor kidney transplantation, our research draws on multiple sources, including (1) insights from patients, health care professionals, provincial and national kidney agencies, and researchers; (2) Ontario's administrative health care databases; (3) clinical trials; and (4) qualitative methodology (surveys, interviews, consensus meetings, Delphi process).

Our research activities in Phase 2 (2022-2026) focus on four key projects:(1) High-quality living kidney donor evaluation: A national consensus conference to define a high-quality living kidney donor evaluation and associated metrics.(2) One-day donor assessment clinic: A streamlined donor evaluation clinic to improve the efficiency of the living kidney donor evaluation.(3) Transplant Ambassador Program: A peer-support program led by patient volunteers to support patients with kidney failure and living kidney donors.(4) Collaboration and equitable access to transplant: Collaboration with patients, health care professionals, and health system leaders to develop, implement, and evaluate solutions with a focus on equity.

Engaging with patients and knowledge users at every stage of our research has enabled the creation of high-quality research, resulting in actionable change. Our work has established 35 national consensus standards for a high-quality living kidney donor evaluation, demonstrated the scalability of a one-day living kidney donor evaluation clinic, expanded a peer-support program, and developed strong system partnerships.

Our work has primarily focused on improving access to living donor kidney transplantation in the province of Ontario. Equitable access to living donor kidney transplants remains a challenge, which we plan to continue focusing on in future iterations of our work.

Our work highlights the vital role of patient-oriented research and the importance of involving patient volunteers in enhancing access to living kidney donation. Together, we remain committed to creating a Canadian system where everyone who needs a living donor kidney transplant can receive one fairly and without delay.