Scholarlink

Background <p>Living donor kidney transplantation (LDKT) is the preferred treatment for patients with end-stage kidney disease, offering longer graft survival and improved quality of life. However, LDKT poses risks to living donors. Black living donors face disproportionately higher risks of postdonation kidney disease than White counterparts, necessitating deeper understanding of the factors contributing to this disparity. This study evaluated the implementation of the <i>APOL1</i> Genetic Testing and Counseling Program at two transplant centers to improve donors’ informed decision-making, which entailed examining the contextual factors influencing its adoption and sustainment.</p> Methods <p>We conducted a&#xa0;mixed-methods evaluation involving semistructured interviews guided by the Consolidated Framework for Implementation Research and surveys with transplant nephrologists to identify facilitators and barriers of intervention implementation.</p> Results <p>Eleven nephrologists participated. Key facilitators included alignment with clinical priorities, strong organizational support, and value attributed to the intended goal of enhancing donors’ informed consent process and to the integration of culturally sensitive counseling practices. Key barriers included time constraints and the need for clear evidence-based guidelines. Participants reported high acceptability, appropriateness, feasibility, and sustainability of the <i>APOL1 </i>Program.</p> Conclusion <p>Our study identified facilitators and barriers that should be addressed to ensure the <i>APOL1</i> program’s sustainment and potential to improve donors’ informed consent. Future research should leverage system-level implementation strategies to overcome identified barriers when taking the <i>APOL1</i> Genetic Testing and Counseling Program to scale.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Contextual factors of implementing APOL1 genetic testing into living kidney donor clinical evaluation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月11日

查看全文
  • James L. Merle,
  • Marissa C. Kuo,
  • Jessica Gacki-Smith,
  • Akansha Agrawal,
  • John Friedewald,
  • Elisa J. Gordon,
  • Justin D. Smith

摘要

Background

Living donor kidney transplantation (LDKT) is the preferred treatment for patients with end-stage kidney disease, offering longer graft survival and improved quality of life. However, LDKT poses risks to living donors. Black living donors face disproportionately higher risks of postdonation kidney disease than White counterparts, necessitating deeper understanding of the factors contributing to this disparity. This study evaluated the implementation of the APOL1 Genetic Testing and Counseling Program at two transplant centers to improve donors’ informed decision-making, which entailed examining the contextual factors influencing its adoption and sustainment.

Methods

We conducted a mixed-methods evaluation involving semistructured interviews guided by the Consolidated Framework for Implementation Research and surveys with transplant nephrologists to identify facilitators and barriers of intervention implementation.

Results

Eleven nephrologists participated. Key facilitators included alignment with clinical priorities, strong organizational support, and value attributed to the intended goal of enhancing donors’ informed consent process and to the integration of culturally sensitive counseling practices. Key barriers included time constraints and the need for clear evidence-based guidelines. Participants reported high acceptability, appropriateness, feasibility, and sustainability of the APOL1 Program.

Conclusion

Our study identified facilitators and barriers that should be addressed to ensure the APOL1 program’s sustainment and potential to improve donors’ informed consent. Future research should leverage system-level implementation strategies to overcome identified barriers when taking the APOL1 Genetic Testing and Counseling Program to scale.