Published in Jama Internal Medicine. Here is a link to the article.
Regenstrief Institute authors: Rachel Patzer, PhD
This pragmatic cluster randomized trial evaluated a multicomponent intervention aimed at overcoming barriers to kidney transplantation among patients with advanced chronic kidney disease (CKD) in Ontario, Canada. The intervention included administrative support, educational resources, patient and donor storytelling, and performance feedback to CKD programs. Among 20,375 eligible patients, the intervention did not significantly improve the rate of completing key transplant-related steps—referral, living donor contact, waitlisting, or transplantation—compared with usual care (adjusted hazard ratio 1.00; 95% CI, 0.87–1.15). The findings highlight the ongoing challenge of improving transplant access and the need for further innovative strategies.
Authors:
Amit X Garg 1 2 3 4 5 6, Seychelle Yohanna 1, Kyla L Naylor 2 3 4, Susan Q McKenzie 5 6, Istvan Mucsi 7 8, Stephanie N Dixon 2 3 4, Bin Luo 2 3, Jessica M Sontrop 2 4, Mary Beaucage 9 10 11, Dmitri Belenko 12, Candice Coghlan 13, Rebecca Cooper 14 15, Lori Elliott 16, Leah Getchell 2 17, Esti Heale 16, Vincent Ki 16 18, Gihad Nesrallah 12 19, Rachel E Patzer 20 21, Justin Presseau 22 23, Marian Reich 24, Darin Treleaven 15 25, Carol Wang 2 26 27, Amy D Waterman 28, Jeffrey Zaltzman 15 29, Peter G Blake 2 16 26
Affiliations:
1Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
2Lawson Health Research Institute and London Health Sciences Centre, London, Ontario, Canada.
3ICES, Ontario, Canada.
4Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
5Kidney Patient & Donor Alliance, Canada.
6Transplant Ambassador Program, Ontario, Canada.
7Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
8Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
9Patient Governance Circle, Indigenous Peoples Engagement and Research Council and Executive Committee, Can-Solve CKD, Vancouver, British Columbia, Canada.
10Provincial Patient and Family Advisory Council, Ontario Renal Network, Toronto, Ontario, Canada.
11Patient co-lead Theme 1-Improve a Culture of Donation, Canadian Donation and Transplantation Research Program, Edmonton, Alberta, Canada.
12Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
13Centre for Living Organ Donation, University Health Network, Toronto, Ontario, Canada.
14Ontario Renal Network, Toronto, Ontario, Canada.
15Trillium Gift of Life Network, Ontario Health, Toronto, Ontario, Canada.
16Ontario Renal Network, Ontario Health, Toronto, Ontario, Canada.
17Can-SOLVE CKD Network, Vancouver BC, Canada.
18Trillium Health Partners, Mississauga, Ontario, Canada.
19Department of Medicine, Humber River Regional Hospital, Toronto, Ontario, Canada.
20Regenstrief Institute, Indianapolis, Indiana.
21Department of Surgery, Division of Transplantation, Indiana University School of Medicine, Indianapolis.
22Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada.
23School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada.
24Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-Solve CKD), Patient Council, Vancouver, British Columbia, Canada.
25McMaster University, Hamilton, Ontario, Canada.
26Division of Nephrology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
27Department of Research Methods, Evidence and Uptake, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
28Department of Surgery and J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas.
29Division of Nephrology, St. Michael’s Hospital, Toronto, Ontario, Canada.
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