Use of Patient Navigators to Reduce Barriers in Living Donation and Living Donor Transplantation

Abstract

The transplant community is facing an important and growing crisis in healthcare disparities, which limits the access of vulnerable populations to successful transplant and its most ideal form, living donor transplantation [1–6]. The time is now to implement strategies that facilitate access to timely living donor transplant and relieve the pressure on a burdened deceased donor waiting list. Patient navigation programs have arisen as distinctive model of patient-centered healthcare delivery to overcome existing disparities in access to healthcare. Originally used in oncology [7–9] and gaining momentum across other specialties, navigators function as educators, sponsors, and allies to patients and their potential donors. Similarly, they provide unique insight, context, and valuable feedback to transplant providers who may be insufficiently aware of the challenges faced by the transplant candidates and the potential donors they care for. Ultimately, patient navigators can help decrease the risk of premature transplant process withdrawal, increase the likelihood of work-up completion, demystify living donor misconceptions and misunderstandings, and help maintain engagement of transplant candidates and their donors. While data are still emerging, the future of patient navigation seems promising, particularly as an intervention to help equalize the access to living donor transplantation to the most vulnerable and under-resourced transplant candidates. In this review, we explore the role of patient navigation programs in solid organ transplantation and how they could help reduce the inequities in living donation and living donor transplantation.