Clinical Transplantation最新文献

{"title":"Willingness of Veterans to Consider Organ and VCA Donation: Effects of a Randomized Educational Trial","authors":"James R. Rodrigue,&nbsp;Jessica Lombardi,&nbsp;Matthew Boger,&nbsp;Aaron Fleishman","doi":"10.1111/ctr.70191","DOIUrl":"https://doi.org/10.1111/ctr.70191","url":null,"abstract":"<div>\u0000 \u0000 <p>There are 18 million living military veterans in the United States, yet this population has not been the focus of educational campaigns to increase donation awareness and willingness to donate organs. This study examined whether willingness to donate organs varies by veteran-inclusive and vascularized composite allograft (VCA)-inclusive messaging. A total of 549 US veterans nondonors were randomized to four education groups: (1) general donation messaging, no veterans or VCA, (2) veteran-inclusive donation messaging, no VCA, (3) veteran- and VCA-inclusive donation messaging, or (4) no donation messaging (Control). Willingness to donate traditional and VCA organs was assessed pre-intervention, post-intervention, and at 3-weeks. Generalized Estimating Equations (GEE) models showed significant group X time interaction effects for traditional (Wald <i>χ</i>² = 91.3, <i>p</i> &lt; 0.001) and VCA (Wald <i>χ</i>² = 36.3, <i>p</i> &lt; 0.001) donation willingness. For traditional donation willingness, improvements were higher in veteran-inclusive messaging groups than the Control group (<i>p</i> &lt; 0.01). There was no difference between veteran-inclusive and non-veteran groups, nor between VCA-inclusive and non-VCA video groups. For VCA donation willingness, significant increases were observed in the veteran-inclusive plus VCA messaging group compared to messaging without veterans or VCA and Control groups (<i>p</i> &lt; 0.03). At follow-up, the education groups had more veterans who registered as donors, compared to the Control group (<i>p</i> = 0.02). Veteran-inclusive donation messaging may not be necessary to increase willingness to donate traditional organs, although it offers some advantages for increasing VCA donation willingness.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generic Versus Brand-Name Immunosuppression Following Heart Transplant: An Analysis of the UNOS Database","authors":"Aviral Mahajan,&nbsp;Jiwon Park,&nbsp;Timothy E. Moore,&nbsp;William L. Baker,&nbsp;Cesar Rodrigo Zoni,&nbsp;Stephen Akinfenwa,&nbsp;Mirghani Mohamed,&nbsp;Matthew Dean,&nbsp;Chittoor Sai-Sudhakar,&nbsp;Yazhini Ravi","doi":"10.1111/ctr.70196","DOIUrl":"https://doi.org/10.1111/ctr.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immunosuppressant medications, such as tacrolimus and mycophenolate mofetil (MMF), are crucial for preventing graft rejection after heart transplantation (HTx). Generic formulations have become available, offering potential cost savings, but concerns exist regarding their clinical bioequivalence compared to brand-name formulations. Current guidelines suggest no increased risk with generic use, but research remains limited. Therefore, this study aims to explore whether the type of immunosuppressant formulation at hospital discharge influences post-transplant outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis utilized data from the United Network for Organ Sharing (UNOS) registry, including HTx recipients from January 2015 to March 2022. Patients were grouped based on their discharge immunosuppressant regimen: dual generic, dual brand-name, or a mix of both tacrolimus and MMF. Demographic and clinical variables were collected. The primary outcome was all-cause mortality and graft failure, assessed using Kaplan-Meier analysis and Cox proportional hazards regression. Multivariable Cox regression was adjusted for recipient and donor characteristics. Statistical significance was set at <i>p</i> &lt; 0.05. This approach allows for a thorough examination of the relationships between immunosuppressant formulations and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 16 529 HTx recipients. The majority (52.0%) were discharged on a dual generic regimen. At 1-year post-transplant, significant differences were observed in treatment for rejection, graft failure, and all-cause mortality among the groups. The dual generic group demonstrated the lowest rates of graft failure (13.6%) and all-cause mortality (13.1%) at 5 years. However, after adjusting for demographic and clinical characteristics using multivariable Cox regression, no significant differences in graft failure or mortality were observed among the immunosuppressant regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite initial differences in unadjusted outcomes, adjusted analyses did not demonstrate a significant difference in graft failure or mortality between brand-name and generic immunosuppressant regimens. These findings suggest that clinicians can confidently prescribe generic immunosuppressants without compromising patient outcomes, potentially leading to substantial healthcare savings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postkidney Transplant Delayed Graft Function Outcomes Are Not Worsened by Deceased Donor Type","authors":"Angela L. Zhou,&nbsp;Suseela Raj,&nbsp;Ekaterina Fedorova,&nbsp;Jacqueline Garonzik-Wang,&nbsp;Didier Mandelbrot,&nbsp;Brad C. Astor,&nbsp;Sandesh Parajuli","doi":"10.1111/ctr.70199","DOIUrl":"https://doi.org/10.1111/ctr.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Kidney-delayed graft function (DGF) is more common in donation after circulatory death (DCD) donors in comparison to donatation after brain death (DBD). We analyzed deceased kidney transplant recipients (DDKTR) at our center between 2005 and 2019, stratified by donor type (DBD vs. DCD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed risk factors for DGF, acute rejection (AR), graft failure (GF), along with the death with functioning graft (DWFG), and the interaction between types of donors for those complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2543 DDKTRs, 804 (32%) were from DCD donors. Older donor age, higher recipient body mass index, and receipt of a depleting induction agent were associated with increased risk for DGF in both DBD and DCD. In contrast, preemptive transplant and female recipient gender were associated with reduced risk. Additional risk factors in DBD, but not in DCD recipients, included higher donor terminal serum creatinine, higher kidney donor profile index, right donor kidney, and prolonged cold ischemia time. Female donors were associated with a reduced risk of DGF only among DCD donors. DGF was associated with higher AR and GF, with no significant differences across donor types, DBD vs. DCD (AR: adjusted hazard ratio [aHR] 2.22 vs. 2.37, p-interaction = 0.65; GF: 3.04 vs. 2.56; p-interaction = 0.47). DGF was associated with a higher risk for DWFG among DBD (aHR: 3.43, 95% CI: 1.96–6.00, <i>p</i> &lt; 0.001) but not with DCD (aHR: 1.90, 95% CI: 0.78–4.61, <i>p</i> = 0.16), with p-interaction of 0.15</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite higher DGF rates in DCD, early adverse outcomes after DGF were similar between deceased donor types and should not deter the utilization of DCD kidneys.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors for Nontraumatic Osteonecrosis of the Femoral Head in Kidney Transplant Recipients: A Comparison of Two Eras (1985–2000 and 2001–2024)","authors":"Edward Y. Cheng,&nbsp;Arthur J. Matas,&nbsp;Lee Houachee,&nbsp;Alireza Mirzaei","doi":"10.1111/ctr.70198","DOIUrl":"https://doi.org/10.1111/ctr.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Historically, osteonecrosis of the femoral head (ONFH) was a major problem following kidney transplantation, occurring in up to 5%–11% of recipients. The development of new immunosuppressive agents permitted steroid minimization protocols, and consequently, the incidence of ONFH has decreased. We studied ONFH trends over four decades and evaluated risk factors in two immunosuppressive eras, pre- and post-2001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Steroid minimization protocols at our center started in 2000. We reviewed records of 1st kidney transplants from January 1985 to May 2024 and compared ONFH incidence and risk factors between the two eras: Era 1 (January 1985–December 31, 2000) and Era 2 (January 2001–May 2024). Cox regression was used to assess for independent factors associated with a higher or lower incidence of ONFH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ONFH incidence in Era 1 was 7.2%; Era 2, 1.1% (<i>p</i> &lt; 0.001). In Era 1, increased risk was associated with heavier weight (HR: 1.017, 95% CI: 1.010–1.023, <i>p</i> &lt; 0.001) and mTOR inhibitors (HR: 4.258, 95% CI: 1.726–10.506, <i>p</i> = 0.002); and decreased risk with diabetes (HR: 0.362, 95% CI: 0.270-0.486, <i>p</i> &lt; 0.001), and statins (HR: 0.452, 95% CI: 0.327–0.625, <i>p</i> &lt; 0.001). In Era 2, increased risk was associated with steroid use (HR: 2.096, 95% CI: 1.071–4.100, <i>p</i> = 0.031) and decreased risk with mycophenolate (HR: 0.471, 95% CI: 0.237–0.935, <i>p</i> = 0.032).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The incidence of ONFH in KTRs has dramatically decreased in the modern immunosuppressive era. Diabetes, statin use, and immunosuppressive medications, specifically mTOR inhibitors and mycophenolate, appear to have varying impacts depending on the immunosuppressive era.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Letermovir as Secondary Prophylaxis in Cytomegalovirus Resistant Pediatric Heart Transplant Recipients","authors":"John-Anthony Coppola,&nbsp;Debbie-Ann Shirley,&nbsp;Emily Martin,&nbsp;Varvara Probst,&nbsp;Dipankar Gupta","doi":"10.1111/ctr.70187","DOIUrl":"https://doi.org/10.1111/ctr.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cytomegalovirus (CMV) is a prevalent DNA virus that is a well-recognized cause of significant complications in post-transplant recipients. Emergence of CMV resistance to standard antiviral agents poses a substantial challenge for appropriate management post-transplantation. Currently, there are no pediatric heart transplant data on the use of novel agents such as letermovir for the management of resistant CMV infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present our experience using letermovir in the management of three pediatric heart transplant recipients with CMV infection who developed resistance to standard therapy. Informed consent was not required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Letermovir was successfully used for secondary prophylaxis in three patients, all with ganciclovir resistant CMV infection due to UL97 mutations, with no evidence of CMV breakthrough infection and no significant side effects observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our experience, letermovir was well tolerated and effective in the management of resistant CMV in pediatric heart transplant recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transplantation Related Mortality Did Not Show Significant Differences in Patients Aged Above 55 Years With Hematological Malignancies Receiving Allogeneic Hematopoietic Stem Cell Transplantation in a Real-World Study","authors":"Jing Liu,&nbsp;Tingting Han,&nbsp;Haixia Fu,&nbsp;Yuhong Chen,&nbsp;Wei Han,&nbsp;Yao Chen,&nbsp;Yuan-yuan Zhang,&nbsp;Lanping Xu,&nbsp;Yu Wang,&nbsp;Xiaodong Mo,&nbsp;Fengrong Wang,&nbsp;Yuqian Sun,&nbsp;Xiaojun Huang,&nbsp;Xiaohui Zhang","doi":"10.1111/ctr.70192","DOIUrl":"https://doi.org/10.1111/ctr.70192","url":null,"abstract":"<div>\u0000 \u0000 <p>Transplantation related mortality (TRM) remains an issue, particularly in older patients with hematological malignancies. In order to assess the TRM and the feasibility of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in older patients, we collected data from a total of 251 patients aged 55–70 years with acute hematological malignancies who received allo-HSCT from April 19, 2011 to June 28, 2022 in our hospital. With the median follow-up of 637 days, the cumulative incidence of TRM for patients above 55 years on Day 100, 1 year, and 2 years was 6.0%, 21.2%, and 26.7%, respectively. Forty-three (17.1%) patients died of TRM, of whom 11 patients died within 100 days after allo-HSCT, including two due to TMA, two due to aGVHD and TMA simultaneously, one due to capillary leak syndrome, and six due to infection. The cumulative incidence of TRM on Day 100, 1 year, and 2 years between the group aged 55–59 and 60–70 years did not show significant differences. Through a Cox regression analysis, platelet engraftment failure, conditioning regimen, grade 3–4 aGVHD, and cytomegalovirus disease were determined as risk factors for TRM in older patients. In conclusion, allo-HSCT is a feasible option for older patients with hematological malignancies.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover Image, Volume 39, Issue 5","authors":"Mattia Corianò,&nbsp;Nicola Pradegan,&nbsp;Andrea Golfetto,&nbsp;Vincenzo Tarzia,&nbsp;Annalisa Angelini,&nbsp;Antonio Gambino,&nbsp;Chiara Tessari,&nbsp;Marny Fedrigo,&nbsp;Giuseppe Toscano,&nbsp;Gino Gerosa,&nbsp;Francesco Tona","doi":"10.1111/ctr.70204","DOIUrl":"https://doi.org/10.1111/ctr.70204","url":null,"abstract":"<p>The cover image is based on the article <i>Impact of Left Ventricular-Vascular Interaction on Long-Term Outcome After Heart Transplantation</i> by Francesco Tona et al., https://doi.org/10.1111/ctr.70178.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Expanding Perspectives on Sarcopenia and Frailty Risk in Heart Transplant Recipients”","authors":"Felipe V. C. Machado,&nbsp;Luis Almenar-Bonet,&nbsp;Trinidad Sentandreu-Mañó,&nbsp;José M. Tomás,&nbsp;Elena Marques-Sule,&nbsp;Pallav Deka,&nbsp;Raquel López-Vilella,&nbsp;Leonie Klompstra,&nbsp;Dominique Hansen","doi":"10.1111/ctr.70194","DOIUrl":"https://doi.org/10.1111/ctr.70194","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of a High Seroconversion Rate 3.2 ± 0.13 Years After Last COVID-19 Vaccination in Heart Transplant Recipients","authors":"Robin Arcani,&nbsp;Pierre Ambrosi","doi":"10.1111/ctr.70190","DOIUrl":"https://doi.org/10.1111/ctr.70190","url":null,"abstract":"<div>\u0000 \u0000 <p>We previously reported a high level of seroconversion 1 year after COVID-19 vaccination in heart transplant recipients when vaccination was performed several years after transplantation. The aim of this study was to measure the seroconversion rate late after vaccination, in the absence of a new vaccine injection. We included 37 patients vaccinated in 2021. We measured immunoglobulin response using TrimericS Diasorin assay at the last visit between October 2024 and February 2025. We found a seroconversion rate of 95%, 3.2 ± 0.13 years after last COVID-19 vaccination in the absence of new vaccine injection. Most of these patients (73%) had a proven COVID-19 infection since vaccination. Interestingly, none of these patients had a severe form of COVID-19. Thus, vaccination, followed by minor COVID-19 infections, effectively prevented severe forms.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Steps of the Kidney Transplant Process: What Are the Experiences of Dialysis Social Workers?","authors":"Macey L. Levan,&nbsp;Katya Kaplow,&nbsp;Max C. Downey,&nbsp;Carolyn N. Sidoti,&nbsp;Rhiannon D. Reed,&nbsp;Kristy Richards,&nbsp;Scott E. Liebman,&nbsp;Elisa J. Gordon,&nbsp;Dianne LaPointe Rudow,&nbsp;Dorry L. Segev,&nbsp;Liise K. Kayler,&nbsp;Carrie Lindower,&nbsp;Laura L. Kimberly","doi":"10.1111/ctr.70182","DOIUrl":"https://doi.org/10.1111/ctr.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dialysis social workers (DSWs) educate and advocate for end-stage kidney disease (ESKD) patients during the kidney transplantation (KT) process. However, little is known about the barriers DSWs face as they help patients get waitlisted and how to best support their efforts. We interviewed DSWs across New York (NY) State to examine their experiences, supports, and challenges in helping dialysis patients progress through KT education, referral, and evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews with DSWs in NY State who had participated or expressed interest in a program designed to educate DSWs about KT and used rapid qualitative analysis to identify themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We interviewed 17 DSWs. Seven themes emerged: (1) DSWs report involvement in KT interest assessment, education, referral, and evaluation support, (2) DSWs report varying nephrologist support in helping patients progress to KT, (3) DSWs perceive social support and adherence as key factors in KT centers’ eligibility determinations, (4) DSWs have knowledge gaps around living donation and appreciate learning about KT from transplant centers and non-profit organizations, (5) Patients express KT concerns and DSWs counsel them about these concerns, (6) DSWs report solutions to help patients complete KT evaluation appointments, and (7) DSWs report communication deficiencies between dialysis centers and transplant centers, and patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Education for DSWs, support from nephrologists, and resources to help patients complete KT evaluation steps facilitated DSW engagement throughout the pre-transplant process, underscoring the need for multi-level, cross-disciplinary programs to support these efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144091647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}