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. 2025 Jan 16;10(4):1122-1130.
doi: 10.1016/j.ekir.2025.01.013. eCollection 2025 Apr.

Patient and Provider Attitudes Toward Patient-Facing Kidney Organ Offer Reporting

Syed Ali Husain  1   2 , Jordan A Rubenstein  1 , Seshma Ramsawak  3 , Anne M Huml  3 , Miko E Yu  1   2 , Lindsey M Maclay  1   2 , Jesse D Schold  4   5 , Sumit Mohan  1   2   6
Affiliations

Patient and Provider Attitudes Toward Patient-Facing Kidney Organ Offer Reporting

Syed Ali Husain et al. Kidney Int Rep. .

Erratum in

Abstract

Introduction: In the United States (US), deceased donor kidney offers are most commonly declined by transplant centers on behalf of waitlisted candidates, without notifying them. We sought to understand patient and provider attitudes toward patient-facing organ offer reporting.

Methods: We conducted a cross-sectional survey of patients, nephrologists, and nephrology social workers on the National Kidney Foundation mailing list and the medical and surgical directors of US kidney transplant programs.

Results: Among 755 patient respondents, 64% wanted to receive organ offer reports. Patients who wanted organ offer information were younger, more likely to be of a non-White race, and more likely to be on dialysis or on the waiting list. Of the patients, 87% reported that centers should be required to tell candidates about the offers they receive, and 62% reported that candidates should be informed after every offer. Among the 107 nephrology respondents, 73% reported that candidates should be provided with organ offer information and 88% reported that they would want to receive a copy of their patients' offer reports. Among 26 transplant program director respondents, 77% reported that candidates should not be notified of offers declined on their behalf. If organ offer reports were required, most program director respondents believed that they should include the reasons offers were declined and should not include offers for kidneys that were ultimately discarded.

Conclusions: Most patients and nephrology providers, but only a minority of transplant program directors, supported the sharing of patient-facing information about individual deceased donor kidney offers that were declined on candidates' behalf.

Keywords: kidney allocation; kidney transplant; shared decision-making.

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Figures

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Graphical abstract
Figure 1
Figure 1
Patient-reported preferences and beliefs.
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References

    1. OPTN Organ Procurement and Transplantation Network (OPTN) Policies. https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf
    1. Huml A.M., Albert J.M., Thornton J.D., Sehgal A.R. Outcomes of deceased donor kidney offers to patients at the top of the waiting list. Clin J Am Soc Nephrol. 2017;12:1311–1320. doi: 10.2215/CJN.10130916. - DOI - PMC - PubMed
    1. Mohan S., Yu M., King K.L., Husain S.A. Increasing discards as an unintended consequence of recent changes in United States kidney allocation policy. Kidney Int Rep. 2023;8:1109–1111. doi: 10.1016/j.ekir.2023.02.1081. - DOI - PMC - PubMed
    1. Husain S.A., King K.L., Pastan S., et al. Association between declined offers of deceased donor kidney allograft and outcomes in kidney transplant candidates. JAMA Netw Open. 2019;2 doi: 10.1001/jamanetworkopen.2019.10312. - DOI - PMC - PubMed
    1. Husain S.A., Brennan C., Michelson A., et al. Patients prioritize waitlist over posttransplant outcomes when evaluating kidney transplant centers. Am J Transplant. 2018;18:2781–2790. doi: 10.1111/ajt.14985. - DOI - PMC - PubMed

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