Abstract

Abstract Background and Aims Close cooperation between nephrologist, nurse coördinator and social workers in a large non academic hospital. By timely starting the process of education and examinations we have increased the possibilities of pre-emptive transplantation Method When a patiënt needs to be informed about renal replacement therapy, the digital program is used by the nephrologist to inform all necessary disciplines involved. They each will make an appointment within the given time slot with te patient. At first the social worker start the education process, preferably, in the home situation. General information about the procedures and actions to be taken in the coming period, is given to the patient and his family/friends. They support patients in making difficult dicisions. Secondly, the nurse coordinator in the process, gives information about all options in renal transplantation and gives an explanation about the test procedures which are necessary to decide if patients are able te receive a kidney and donors are appropriate candidates. In case of availability of a potential donor, information is directly given about living donation and the procedure can directly be started. The nurse coordinator ensures that the patient and potential donor complete all required tests in the shortest time possible in their own hospital. The close cooperation consists of daily deliberation between all disciplines and quickly changing the process of a patient or donor when needed. The progress is reported in the digital file and everyone involved will be informed. Results From 2013 until 2020 516 patients entered the program. 575 donors ( for 348 recipients) entered the program. 191 couples have been approved ans presented for transplantation of which 87 couples have been transplanted, 61 couples have been put on hold because of a stabilised kidney function. 40 couples are still in the work up program. 44 recipients were not transplantable due to medical/psychological reasons. The median work up time of the procedure of the recipients was 260 days from start of the process to transfer tot he transplant centre. (2017) Various patient/medical retarding factors are discribed. The median work up time fort he donors was 191 days (2017) days from start of the process to transfer tot the transplant centre. Various donor/medical retarding factors are discribed. Conclusion Patients and family are well informed about the treatment options, with a special attention for kidney transplantation. The efficient work up program in the patients treating hospital, results in a significant improvement of the possibility of pre-emptive renal transplantation, or otherwise, patients are earlier registered on the waiting list.

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