Slominska A, Loban K, Kinsella EA, Ho J, Sandal S. Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients. World J Transplant 2024; 14(4): 97474 [DOI: 10.5500/wjt.v14.i4.97474]
Corresponding Author of This Article
Shaifali Sandal, FRCP (C), MD, Associate Professor, Department of Medicine, McGill University Health Centre, 1001 boul. Decarie, Montreal H4A3J1, QC, Canada. Shaifali.sandal@mcgill.ca.
Research Domain of This Article
Transplantation
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Dec 18, 2024; 14(4): 97474 Published online Dec 18, 2024. doi: 10.5500/wjt.v14.i4.97474
Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients
Anita Slominska, Katya Loban, Elizabeth Anne Kinsella, Julie Ho, Shaifali Sandal
Anita Slominska, Katya Loban, MEDIC Program, Research Institute of the McGill University Health Centre, Montreal H4A3J1, QC, Canada
Elizabeth Anne Kinsella, Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal H4A3J1, QC, Canada
Julie Ho, Department of Medicine, University of Manitoba, Winnipeg R3A1R9, MB, Canada
Shaifali Sandal, Department of Medicine, McGill University Health Centre, Montreal H4A3J1, QC, Canada
Author contributions: Sandal S was responsible for idea and concept; Sandal S, Slominska A, and Loban K were responsible for creating the first draft of manuscript; Kinsella EA and Ho J reviewed and revised the manuscript critically for important intellectual content; all authors have read and approved the final manuscript.
Conflict-of-interest statement: Dr. Shaifali Sandal has received an education grant from Amgen Canada to improve the care of patients with graft failure. The other authors have no relevant disclosures.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shaifali Sandal, FRCP (C), MD, Associate Professor, Department of Medicine, McGill University Health Centre, 1001 boul. Decarie, Montreal H4A3J1, QC, Canada. Shaifali.sandal@mcgill.ca.
Received: May 31, 2024 Revised: July 31, 2024 Accepted: August 6, 2024 Published online: December 18, 2024 Processing time: 111 Days and 10.5 Hours
Abstract
Kidney transplantation (KT), although the best treatment option for eligible patients, entails maintaining and adhering to a life-long treatment regimen of medications, lifestyle changes, self-care, and appointments. Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs. Even when transplants are successful, for some patients the adjustment to life post-transplant can be challenging and psychological difficulties, economic challenges and social isolation have been reported. About 50% of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care. This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation. A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes. We propose the "supportive care in transplantation" care model to operationalize a patient-centered approach in transplantation. This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates. Multi-dimensionality, multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model. We conclude by proposing the potential advantages of this approach to patients and healthcare systems.
Core Tip: Kidney transplant recipients and candidates face several uncertainties in their care journey and have several expressed unmet healthcare needs. We recommend a structured and comprehensive approach to transplant care across the entire continuum of a transplant patient’s journey similar to what has been developed in the field of oncology. The supportive care in transplantation model can operationalize patient-centered care and build on the efforts of other researchers in the field. We postulate that such a model would significantly improve care delivery and patients’ experiences and outcomes and potentially decrease healthcare utilization and cost.
