Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients

Table 1 The challenging elements within different phases of a kidney transplant recipient’s journey

Waitlisting to transplantation

Transplant eligibility/candidacy

Living donor candidacy, if available

Support and preparation for various outcomes

Death

Ineligibility

Health deterioration

Being re-activated after being inactivated

Symptom burden

Health maintenance

Vaccination and preventative care

Kidney transplantation

Support and preparation for various outcomes

Graft failure

Death

Rejection

Surgical complications

Medication management

Short and long-term medical complications

Short and long-term infectious complications

Risk of malignancy

Symptom burden

Health maintenance

Vaccination and preventative care

Isolation (no longer on dialysis)

Return to workforce

Graft failure

Support and preparation for various outcomes

Death

Re-listing and re-transplantation

Ineligibility

Psychosocial support (patient, caregiver, living donor)

Transition of care

Immunosuppression plan

Medical complications

Infectious complications

Risk of malignancy

Symptom burden

Health maintenance

Vaccination and preventative care

Table 2 The postulated benefits of supportive care in transplantation care model

For the patient and families

Improve quality of life

Decrease symptom burden

Facilitate self-management

Improve adherence

Decrease risk of graft loss

Decrease risk of mortality

Improve end-of-life care delivery

Among patients with graft failure

Facilitate transitions of care

Improve outcomes

Facilitate re-transplantation

Decrease caregiver burden

For public health and healthcare

Decrease healthcare utilization

Reduce emergency visits

Minimize need for hospitalizations

Increase patient return to workforce

Maximize organ utility

Social return on investment

Improve collaborations between care teams

For research progress

Identify research priorities

Create collaborative networks

Opportunities for patient partnerships

Improve feasibility of trials