Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey

Background: Transplanting less-than-ideal (LTI) kidneys could help optimize organ utilization, but little is known about how patients and caregivers perceive the allocation process, waitlist, or LTI kidneys. Objective: To explore the perspectives of patients and caregivers on the Canadian kidney tra...

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Main Authors: Marie-Chantal Fortin, Fabian Ballesteros Gallego, Héloise Cardinal, Manpreet Kaur, Rahul Mainra, Sylvain Patoine, Nicola Rosaasen, Holly Mansell
Format: Article
Language:English
Published: SAGE Publishing 2025-04-01
Series:Canadian Journal of Kidney Health and Disease
Online Access:https://doi.org/10.1177/20543581251324608
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author Marie-Chantal Fortin
Fabian Ballesteros Gallego
Héloise Cardinal
Manpreet Kaur
Rahul Mainra
Sylvain Patoine
Nicola Rosaasen
Holly Mansell
author_facet Marie-Chantal Fortin
Fabian Ballesteros Gallego
Héloise Cardinal
Manpreet Kaur
Rahul Mainra
Sylvain Patoine
Nicola Rosaasen
Holly Mansell
author_sort Marie-Chantal Fortin
collection DOAJ
description Background: Transplanting less-than-ideal (LTI) kidneys could help optimize organ utilization, but little is known about how patients and caregivers perceive the allocation process, waitlist, or LTI kidneys. Objective: To explore the perspectives of patients and caregivers on the Canadian kidney transplant allocation process, waitlist, and LTI kidneys. Design: Electronic survey. Setting: Canada. Patients: Transplant recipients, candidates, and caregivers. Methods: A bilingual electronic national survey was administered from January to March 2024. The questionnaire contained sections on demographics, perceptions of organ allocation and acceptance, LTI kidneys, and educational preferences. Descriptive analysis was performed. Results: Two hundred fifty-one responses were analyzed, including patients (63%, n = 159), and caregivers (37%, n = 92), from 11 provinces and territories. Three-quarters (74%, n = 186) understood how patients are placed on the waiting list, and 65% (n = 162) understood how donor kidneys are allocated, but 72% (n = 181) and 68% (n = 171) wanted more information about the waitlist and donor kidney allocation criteria, respectively. Approximately 20% felt that the waitlist and allocation processes were not transparent. Awareness about the option to refuse a deceased donor kidney offer was high (69%, n = 174), yet nearly half of respondents (46%, n = 115) expressed concern about being disadvantaged if an offer for a deceased donor kidney was refused. One-third of participants (33%, n = 83) were open to accepting an LTI kidney. Limitations: Compared to the general population, more study participants were white, and the majority were educated and financially at ease. This limits the generalizability of the results. Conclusion: Enhanced communication is required to improve transparency and information about the allocation system and waitlist in Canada.
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spelling doaj-art-908e653ffda64389bb921d1e9b1689452025-08-20T03:04:27ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812025-04-011210.1177/20543581251324608Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian SurveyMarie-Chantal Fortin0Fabian Ballesteros Gallego1Héloise Cardinal2Manpreet Kaur3Rahul Mainra4Sylvain Patoine5Nicola Rosaasen6Holly Mansell7Centre hospitalier de l’Université de Montréal, QC, CanadaCentre hospitalier de l’Université de Montréal, QC, CanadaCentre hospitalier de l’Université de Montréal, QC, CanadaCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, CanadaPatient and Family Advisor, Montréal, QC, CanadaCentre hospitalier de l’Université de Montréal, QC, CanadaCentre hospitalier de l’Université de Montréal, QC, CanadaBackground: Transplanting less-than-ideal (LTI) kidneys could help optimize organ utilization, but little is known about how patients and caregivers perceive the allocation process, waitlist, or LTI kidneys. Objective: To explore the perspectives of patients and caregivers on the Canadian kidney transplant allocation process, waitlist, and LTI kidneys. Design: Electronic survey. Setting: Canada. Patients: Transplant recipients, candidates, and caregivers. Methods: A bilingual electronic national survey was administered from January to March 2024. The questionnaire contained sections on demographics, perceptions of organ allocation and acceptance, LTI kidneys, and educational preferences. Descriptive analysis was performed. Results: Two hundred fifty-one responses were analyzed, including patients (63%, n = 159), and caregivers (37%, n = 92), from 11 provinces and territories. Three-quarters (74%, n = 186) understood how patients are placed on the waiting list, and 65% (n = 162) understood how donor kidneys are allocated, but 72% (n = 181) and 68% (n = 171) wanted more information about the waitlist and donor kidney allocation criteria, respectively. Approximately 20% felt that the waitlist and allocation processes were not transparent. Awareness about the option to refuse a deceased donor kidney offer was high (69%, n = 174), yet nearly half of respondents (46%, n = 115) expressed concern about being disadvantaged if an offer for a deceased donor kidney was refused. One-third of participants (33%, n = 83) were open to accepting an LTI kidney. Limitations: Compared to the general population, more study participants were white, and the majority were educated and financially at ease. This limits the generalizability of the results. Conclusion: Enhanced communication is required to improve transparency and information about the allocation system and waitlist in Canada.https://doi.org/10.1177/20543581251324608
spellingShingle Marie-Chantal Fortin
Fabian Ballesteros Gallego
Héloise Cardinal
Manpreet Kaur
Rahul Mainra
Sylvain Patoine
Nicola Rosaasen
Holly Mansell
Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey
Canadian Journal of Kidney Health and Disease
title Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey
title_full Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey
title_fullStr Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey
title_full_unstemmed Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey
title_short Patient and Caregiver Perceptions on the Allocation Process and Waitlist, and Accepting a Less-Than-Ideal Kidney: A Canadian Survey
title_sort patient and caregiver perceptions on the allocation process and waitlist and accepting a less than ideal kidney a canadian survey
url https://doi.org/10.1177/20543581251324608
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