A health systems approach to improve the care of kidney transplant recipients with graft failure

Kidney transplantation can significantly improve the lives of patients with kidney disease. However the life span of a transplanted kidney is limited, and many patients experience graft failure. Patients with graft failure do extremely poorly. They experience a life-altering event for which they are often poorly prepared and poorly supported. Many are not re-transplant candidates and some die after experiencing graft failure. It is known that patients with graft failure experience fragmented transitions of care between the transplant and dialysis teams. Patient perspectives are poorly researched and poorly understood, thus poorly translated into clinical practice. This research project aims to obtain the perspectives of patients who are in different stages of graft failure as well as their caregivers, living kidney donors and healthcare professionals. We then aim to develop healthcare approaches to improve care delivery that are consistent and aligned with the self-identified needs and expectations of patients with graft failure and their caregivers. We want to describe the unique experiences and needs of patients in different stages of graft failure. We also want to identify factors that can improve the care, outcomes, and well-being of these patients and what patients think impedes their access to re-transplantation. We will use well-established qualitative methods that are largely unexplored in the field of kidney transplantation. Our team includes nationally recognised transplant clinicians, researchers, and leaders. With this project, we hope to develop the field of Supportive Care in Transplantation that supports patients across the entire spectrum of transplantation care. This care model will help implement earlier integration of physical symptoms, and psychological and functional support to KTRs whilst guiding clinical practice and supporting the education of current and future healthcare teams.