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Tool to aid patients in selecting a liver transplant center. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Schaffhausen, C. R., Bruin, M. J., Chu, S. n., Fu, H. n., McKinney, W. T., Schladt, D. n., Snyder, J. J., Kim, W. R., Lake, J. R., Kasiske, B. L., Israni, A. K. 2020

Abstract

Variations in candidate and donor acceptance criteria may influence access and mortality for liver transplantation. We sought to understand how recipient and donor characteristics vary across centers and how patients interpret this information. This data was used to develop a tool to provide tailored information to candidates seeking a center (www.transplantcentersearch.org). We analyzed liver recipient data from the Scientific Registry of Transplant Recipients to determine how recipient and donor characteristics, e.g. age, Medicaid use, and human immunodeficiency virus status, vary across programs. Data included recipients and donors at each U.S. program between 1/1/2015 and 12/31/2017. The variation of recipient and donor characteristics was plotted, with centers stratified by total transplant volume and volume of each characteristic. A subset of characteristics was plotted over 3 years to show variation over time. We created mockups of potential reports displaying recipient characteristics alongside pre- and posttransplant outcomes and presented them at patient and family interviews and focus groups to solicit feedback. 39 individuals participated: 10 pilot interviews included candidates seeking liver transplant at the University of Minnesota (UMN); 5 focus groups included 13 UMN candidates, 6 UMN family members, and 10 national recipients. Transcripts were analyzed by 2 researchers using a thematic analysis. Several themes emerged: 1) Candidates experience gaps in existing education about center options. 2) Patients requested information about how selection criteria might impact access to transplant. 3) Information tailored to a candidate's medical characteristics can inform decisions. Characteristics shown on mockups varied across centers (p<0.01). Variation was widespread for small and large centers. Conclusion: Variation exists in recipient and donor characteristics across centers. Liver transplant patients provide positive feedback upon viewing patient-specific search tools.

View details for DOI 10.1002/lt.25715

View details for PubMedID 31923342