MO989: Ap'tx: Preliminary Results of A Randomized Controlled Trial on Telemedicine Implementation in Kidney Transplantation

Abstract

Abstract BACKGROUND AND AIMS Telemedecine is a matter of growing interest in transplantation. However, its real added value is uncertain. In 2018, we have started to study the medico-economic impact of a less stringent on-site follow-up of our kidney transplant recipients (KTR) using Ap'Telecare®. We present here the first report focusing on KTR with a 2 years follow-up. METHOD The Ap'Tx study (NCT03750331) is a prospective controlled randomized trial testing the hypothesis that monitoring stable KTR (at least 3 months after transplantation) with Ap'Telecare® is non inferior as compared to a conventional follow-up in terms of the occurrence of graft dysfonction (defined as a decrease in eGFR of 20% or more). On-site consultation scheduling was two times less frequent for KTR followed by Ap'Telecare®. Secondary endpoints are the impact of a remote follow-up by Ap'Telecare® on medical workload, economic saving and quality of life. RESULTS Five hundred and ninety KTR have been randomized so far with 256 of them having a follow-up of 2 years. Among all KTR approached to participate in the study, 37% were not included mainly due to the impossibility to access internet (44%) or to mastered the app (36%). After randomization, 11% of KTR were considered as noncompliant in adequately using Ap'Telecare®. Over the 2-year study duration, graft dysfunction occurred in 8.5% and 12% of KTR in the Ap'telecare® and conventional arm, respectively (not significant). Medical time dedicated to handling daily lab results was decreased by a factor 3 for KTR using Ap'Telecare®. CONCLUSION This preliminary report of Ap'Tx suggest that a partial and reasonable remote follow-up of selected KTR is both feasible and safe. Determining the nature of factors associated with a wider implementation of Ap'Telecare® is important.