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Updated: Jul 16, 2026
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
An Interactive Virtual Nephrologist to Engage Patients With Advanced CKD About Transplantation
Peter P Reese1, Danish Tamboli2, Vishnu Potluri3
1Vanderbilt Center for Transplant Science, Vanderbilt University Medical Center, Nashville, TN.
Rationale & Objective:
Despite advantages in survival and quality of life with kidney transplantation (KT) compared to other treatments for kidney failure requiring dialysis, many patients do not receive sufficient information about KT or have concerns about it. New artificial intelligence capabilities enable the creation of virtual agents to supplement human efforts to engage patients about treatment options.
Study Design:
Single arm, open label trial with the primary outcome assessed pre- and post-intervention.
Setting & Participants:
Adults (≥18 and <75 years) with eGFR <25 mL/min/1.73 m2 in a large health system.
Interventions:
Our group developed the virtual transplant nephrologist - an interactive, video-based platform to provide personalized education about KT. Meetings could occur anytime from a smartphone with a weblink. Participants first selected the demographic profile of their virtual nephrologist. Participants then self-tailored the encounter, choosing among 11 topics, pausing, changing the topic, and requesting more information.
Outcome:
The primary outcome was the difference in participants' intentions to speak to their human doctor about KT, before versus after the intervention, assessed on a 5-point Likert-like scale.
Results:
Participants had a median age of 66 years; 59% were female and 50% were Black. Female and Black participants demonstrated preferences to select a gender (p<0.001) or race (p<0.001) concordant virtual nephrologist, respectively. Participants spent a median 12.6 minutes reviewing a median of 11 topics in the encounter. The primary outcome of intention to speak to a human clinician about KT increased significantly after the virtual encounter (mean increase 0.30; p<0.001).
Limitations:
The clinical significance of the outcome is uncertain.
Conclusions:
Virtual clinicians offer a promising path to education and engagement about complex treatments such as KT. This customizable approach to providing high quality information about KT using a virtual clinician warrants more definitive testing in a randomized trial.
Insights
A virtual transplant nephrologist significantly increased patients' intention to discuss kidney transplantation (KT). This AI-powered tool offers personalized education, showing promise for improving patient engagement with complex medical options.
Area of Science:
- Artificial Intelligence in Healthcare
- Nephrology and Transplant Medicine
- Patient Education Technology
Background:
- Kidney transplantation (KT) offers superior survival and quality of life compared to dialysis for kidney failure.
- Many patients lack adequate information or harbor concerns regarding KT, hindering treatment decisions.
- Artificial intelligence (AI) presents opportunities to enhance patient education and engagement with complex medical treatments.
Purpose of the Study:
- To evaluate the effectiveness of a virtual transplant nephrologist in improving patient intentions to discuss kidney transplantation.
- To assess patient engagement with a personalized, interactive AI-driven educational platform about kidney transplantation.
Main Methods:
- A single-arm, open-label trial involving adult patients with advanced kidney disease (eGFR <25 mL/min/1.73 m²).
- Development of an interactive, video-based virtual transplant nephrologist platform allowing personalized education and topic selection.
- Primary outcome measured by the change in participants' intention to speak with a human clinician about KT pre- and post-intervention using a 5-point Likert-like scale.
Main Results:
- Participants (median age 66, 59% female, 50% Black) showed preferences for demographic-concordant virtual nephrologists.
- Patients engaged with the platform for a median of 12.6 minutes, reviewing a median of 11 topics.
- A significant increase in the intention to discuss KT with a human clinician was observed post-intervention (mean increase 0.30; p<0.001).
Conclusions:
- Virtual clinicians, like the developed virtual transplant nephrologist, represent a promising approach for patient education and engagement regarding complex treatments such as KT.
- The customizable, AI-driven platform effectively increased patient intention to seek further information about kidney transplantation.
- Further validation through a randomized controlled trial is warranted to confirm the clinical significance and broader applicability of this virtual clinician approach.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:26Kidney Transplant II: Surgical Procedure
01:28Chronic Kidney Disease III: Interprofessional Care
01:25Chronic Kidney Disease I: Introduction
01:18Chronic Kidney Disease IV: Nursing Management