Patient Perspectives on the Use of Aging Metrics for Kidney Transplant Decision-Making.
Akanksha Nalatwad, Evelien E Quint, Maria Fazal and 8 others
PMID 39105243WHAT IT FOUND
Kidney transplant candidates opposed denying listing solely on age (seventy-five-point six percent), frailty (46.5%), or cognitive impairment (45.9%).
Most wanted centers to help improve health before waitlisting.
Key findings
01Seventy-five-point six percent of participants disagreed or strongly disagreed that it was fair to prevent older patients from being waitlisted for a transplant due to age.
0246.5% of participants disagreed that it was fair to prevent patients from being waitlisted because they were frail, and 45.9% disagreed that it was fair to prevent patients from being waitlisted because they were cognitively impaired.
03Seventy-five-point seven percent of participants agreed or strongly agreed that transplant centers should help frail patients improve their health status before waitlisting. Seventy-point seven percent of participants agreed or strongly agreed that transplant centers should help cognitively impaired patients improve their health status before waitlisting.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All participants came from one urban transplant center, so the views may not match other centers. 55 of 100 participants did not have frailty scores because in-person research paused during the pandemic. The sample included more Black patients (50.0% vs 28.8%), female patients (44.0% vs 38.1%), and older patients (47.0% vs 20.2%) than national kidney transplant waitlist patients. Participants may have preferred hypothetical candidates who shared their own age, frailty, or cognitive status. Only 100 participants completed the survey, with a 61.3% response rate.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read this survey as evidence that frailty or cognitive impairment should not affect transplant outcomes. It reports patients' opinions about listing criteria, not outcomes after transplantation.