Implementation of a 1-Day Living Kidney Donor Evaluation Program: A Qualitative Analysis of Donor Candidate and Stakeholder Perspectives

Abstract

IntroductionA lengthy donor evaluation process hinders living kidney donor transplantation (LDKT). At The Ottawa Hospital, one-day evaluation process was recently developed, with a goal to accelerate the determination of donor suitability. The major objective of this study was to solicit feedback from donor candidates and key stakeholders who participated in the one-day living kidney donor evaluation process, to determine the program’s acceptability and factors influencing its implementation elsewhere. MethodsSemi-structured interviews were conducted with donor candidates who participated in the one-day living kidney donor evaluation process, and with stakeholders instrumental to the implementation strategy. Interviews were conducted via videoconference or by telephone from May 2022-December 2022. Directed content analysis was conducted using two unique frameworks for stakeholder and donor candidate interviews. ResultsOur study included 13 stakeholders and 18 donor candidates, of whom 16 (89%) were women and 7 (39%) proceeded to kidney donation. Eighteen (100%) perceived the process to be both time- and cost-effective, due to reduced travel and missed work time. Thirteen (72%) felt that the one-day evaluation may accelerate determination of donor suitability. Sequential virtual sessions with a nurse and social worker in advance of the evaluation day were seen as providing critical education and support. Among stakeholders, 11 (85%) emphasized donor candidate care and faster candidacy determinations. ConclusionThe one-day evaluation process was preferred by most donor candidates, and was perceived as time- and cost-effective by most interviewees. An expedited, one-day evaluation may accelerate determination of donor suitability and improve LDKT rates.