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ASN: Multicomponent Intervention Does Not Increase Steps Toward Kidney Transplant

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 8, 2023.

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Nov. 8, 2023 -- A multicomponent intervention does not increase the rate of completed steps toward receiving a kidney transplant, according to a study published online Nov. 3 in JAMA Internal Medicine to coincide with Kidney Week, the annual meeting of the American Society of Nephrology, held from Nov. 2 to 5 in Philadelphia.

Amit X. Garg, M.D., Ph.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues examined the effect of a multicomponent intervention designed to target barriers that prevent eligible patients from completing steps toward receipt of a kidney transplant in a two-arm trial involving all 26 chronic kidney disease (CKD) programs in Ontario. The intervention was composed of four components: administrative support to set up local quality improvement teams; educational resources; a story-sharing initiative for transplant recipients and living donors; and performance reports and oversight by administrative leaders. The primary outcome was the rate of completion of steps, with each patient able to complete four steps (referred to transplant center for evaluation; had a potential living donor contact a transplant center for evaluation; added to the deceased donor wait list; and received a transplant from a living or deceased donor).

The 26 CKD programs included 20,375 potentially transplant-eligible patients with advanced CKD (9,780 patients from 13 programs in the intervention group and 10,595 patients from 13 programs in the usual-care group). The researchers observed no significant difference between the groups in the step completion rate (24.8 versus 24.1 steps per 100 patient-years), despite evidence of intervention uptake.

"Improving access to transplantation remains a global priority that requires substantial effort," the authors write.

Several authors disclosed ties to Astellas Canada.

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