McGill University Health Centre Research Institute Researchers Have Published New Study Findings on Kidney Transplants (Living Donor Kidney Transplantation in Quebec: A Qualitative Case Study of Health System Barriers and Facilitators): Transplant Medicine – Kidney Transplants

Insurance Daily News

2023 FEB 07 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New study results on kidney transplants have been published. According to news reporting originating from Montreal, Canada, by NewsRx correspondents, research stated, “Patients with kidney failure represent a major public health burden, and living donor kidney transplantation (LDKT) is the best treatment option for these patients. Current work to optimize LDKT delivery to patients has focused on microlevel interventions and has not addressed interdependencies with meso and macro levels of practice. We aimed to learn from a health system with historically low LDKT performance to identify facilitators and barriers to LDKT.”

Financial supporters for this research include American Society of Transplantation; Kidney Foundation of Canada.

The news journalists obtained a quote from the research from McGill University Health Centre Research Institute: “Our specific aims were to understand how LDKT delivery is organized through interacting macro, meso, and micro levels of practice and identify what attributes and processes of this health system facilitate the delivery of LDKT to patients with kidney failure and what creates barriers. We conducted a qualitative case study, applying a complex adaptive systems approach to LDKT delivery, that recognizes health systems as being made up of dynamic, nested, and interconnected levels, with the patient at its core. The setting for this case study was the province of Quebec, Canada. Participants: Thirty-two key stakeholders from all levels of the health system. This included health care professionals, leaders in LDKT governance, living kidney donors, and kidney recipients. Semi-structured interviews with 32 key stakeholders and a document review were undertaken between February 2021 and December 2021. Inductive thematic analysis was used to generate themes. Overall, we identified strong links between system attributes and processes and LDKT delivery, and more barriers than facilitators were discerned. Barriers that undermined access to LDKT included fragmented LDKT governance and expertise, disconnected care practices, limited resources, and regional inequities. Some were mitigated to an extent by the intervention of a program launched in 2018 to increase LDKT. Facilitators driven by the program included advocacy for LDKT from individual member(s) of the care team, dedicated resources, increased collaboration, and training opportunities that targeted LDKT delivery at multiple levels of practice. Limitations: Delineating the borders of a ‘case’ is a challenge in case study research, and it is possible that some perspectives may have been missed. Participants may have produced socially desirable answers.”

According to the news reporters, the research concluded: “Our study systematically investigated real-world practices as they operate throughout a health system. This novel approach has cross-disciplinary methodological relevance, and our findings have policy implications that can help inform multilevel interventions to improve LDKT.”

For more information on this research see: Living Donor Kidney Transplantation in Quebec: A Qualitative Case Study of Health System Barriers and Facilitators. Canadian Journal of Kidney Health and Disease, 2023,10. (Canadian Journal of Kidney Health and Disease - http://cjk.sagepub.com/). The publisher for Canadian Journal of Kidney Health and Disease is SAGE Publishing.

A free version of this journal article is available at https://doi.org/10.1177/20543581221150675.

Our news editors report that additional information may be obtained by contacting Anna Horton, McGill University Health Center, Montreal, QC, Canada. Additional authors for this research include Katya Loban, Marie-Chantal Fortin, Sylvie Charbonneau, Peter Nugus, Michel R. Paquet, Prosanto Chaudhury, Marcelo Cantarovich, Shaifali Sandal.