Perspectives Toward Kidney Transplantation Amongst Individuals With Kidney Failure in Canada: A Qualitative Study

An understanding of perspectives toward kidney transplant amongst individuals with kidney failure is integral to supporting treatment-related decision-making and preparing for life post-transplant, yet this has not been studied in a Canadian context. Therefore, the objective of this study was to examine the perspectives of individuals with kidney failure in Canada regarding kidney transplant.

Adults (18-75y) from four Canadian provinces who either had initiated dialysis within the prior 6 months or were preemptively referred for kidney transplantation within the prior 3 months were recruited to participate in focus group discussions (FGDs) or individual interviews. Data were analyzed using inductive thematic analysis.

Fifteen individuals participated in one of four FGDs (n=13) or a semi-structured interview (n=2). Seven were on dialysis and eight were pre-dialysis (four and six of whom had been referred for transplant, respectively). Overall, participants expressed a clear preference for transplant compared to dialysis. Participants' willingness to consider transplant was influenced by their (1) relationship with the healthcare team, recognition of (2) the necessity of treatment, the (3) potential to live a "normal" life, and knowledge of (4) others' experiences with transplant. Despite a preference for transplant, participants expressed (5) concerns regarding securing a living donor and a sense of having (6) a lack of control over the transplant referral process.

In this study, we evaluated perceptions towards kidney transplantation amongst individuals with kidney failure in Canada. Understanding potential concerns regarding future transplant may lead to improved patient-centered education, communication and psychosocial support strategies to empower patients to confidently make treatment-related decisions.