Introduction: This study explored patient-provider communication about live donor kidney transplantation (LDKT) during the medical evaluation for transplant candidacy.
Methods: Patients and providers were recruited from two abdominal transplant programs in the northeastern US. Samples of two kidney transplant programs in the East were collected. Eligible patients and providers were included in the study. All participants provided written informed consent to participate and permission to record the medical consultation. The audiorecorded consultations were transcribed verbatim for analysis and the transcripts were uploaded to MAXQDA to facilitate qualitative analysis of instrumental, persuasive, relational and affective communication.
Results: 35 patients participated. Patients averaged 51.9 years; 45.7% were female and 57.1% were African American (34.3% White and 8.6% Latinx). All participants were willing to receive a LDKT, however only 31.4% had requested living donation. Of over 33,000 utterances coded, only 14.4% of the utterances were related to LDKT, and 2812 (8.5%) were related to living donors, with 17 (48.6%) candidates reporting provider communication as adequate. Nearly half (48.6%) of patients rated providers’ communication as ‘poor’ or ‘fair’.
Conclusions: LDKT is the optimal treatment for renal failure. However, discussions among transplant providers regarding live donor kidney transplantation are only a small part of the conversation during the medical evaluaton for kidney transplantation.