Determinants of kidney transplant candidates’ decision to accept organ donor intervention transplants and participate in post-transplant research: A conjoint analysis

Elisa J. Gordon*, Peter Abt, Jungwha Lee, Elizabeth Knopf, Caitlin Phillips, Francisca Bermudez, Lakshman Krishnamurthi, Huseyin S. Karaca, Robert Veatch, Richard Knight, Paul T. Conway, Sue Dunn, Peter P. Reese

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Deceased organ donor intervention research aims to increase organ quality and quantity for transplantation. We assessed the proportion of kidney transplant candidates who would accept “intervention organs,” participate in organ intervention research, and factors influencing acceptance. Kidney transplant candidates were presented 12 hypothetical scenarios, which varied three attributes, donor age, predicted waiting time to receive another organ offer, and research risk to the organ. Candidates were also randomly assigned to one of two conditions varying recipient risk. For each scenario, candidates agreed to accept the intervention organ or remain waitlisted. We fit a multivariable logit model to determine the association between scenario attributes and the acceptance decision. Of 249 participants, most (96%) accepted intervention organs under some or all conditions. Factors independently associated with candidates’ greater likelihood of accepting an intervention organ included: low risk to the kidney from the intervention (OR 20.53 [95% Confidence Interval (CI), 13.91-30.29]); younger donor age (OR 3.72 [95% CI, 2.83-4.89]), longer time until the next organ offer (OR 3.48 [95% CI, 2.65-4.57]), and greater trust in their transplant physician (OR 1.03 [95% CI, 1.00-1.06]). Candidates with a lower likelihood of acceptance had been waitlisted longer (OR 0.97 per month [95% CI, 0.96-0.99]) and were Black (OR 0.21 [95% CI, 0.08-0.55]). Most candidates would accept an intervention organ, which should encourage transplant leaders to conduct deceased donor organ intervention trials.

Original languageEnglish (US)
Article numbere14316
JournalClinical Transplantation
Volume35
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • deceased donor
  • decision making
  • ethics and public policy
  • human subjects research
  • organ procurement and allocation
  • patient perspectives
  • social sciences

ASJC Scopus subject areas

  • Transplantation

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