Suspension and resumption of kidney transplant programmes during the COVID-19 pandemic: perspectives from patients, caregivers and potential living donors - a qualitative study.

Publisher: Frontiers Media S. A Country of Publication: Switzerland NLM ID: 8908516 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2277 (Electronic) Linking ISSN: 09340874 NLM ISO Abbreviation: Transpl Int Subsets: MEDLINE

Publication: 2022- : Lausanne, Switzerland : Frontiers Media S. A.
Original Publication: [Heidelberg, FRG] : Springer International, 1988-

Attitude to Health* ; Health Services Accessibility*/organization & administration ; Infection Control*/organization & administration; COVID-19/*prevention & control ; Caregivers/*psychology ; Kidney Transplantation/*psychology ; Living Donors/*psychology; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Australia/epidemiology ; COVID-19/epidemiology ; Female ; Focus Groups ; Humans ; Male ; Middle Aged ; Pandemics ; Qualitative Research ; Young Adult

Many countries have suspended kidney transplantation programmes during the COVID-19 pandemic because of concerns for patient safety and the shortage of healthcare resources. This study aimed to describe patient, family member and potential donor perspectives on the suspension and resumption of kidney transplant programmes due to COVID-19. We conducted seven online focus groups involving 31 adult kidney transplant candidates (n = 22), caregivers (n = 4) and potential donors (n = 5). Transcripts were analysed thematically. We identified five themes: cascading disappointments and devastation (with subthemes of shattering hope, succumbing to defeat, regret and guilt); helplessness and vulnerability (fear of declining health, confronted by the threat of and change in dialysis, disconnected from health care, susceptibility to infective complications); stress from uncertainty (confusion from conflicting information, unable to forward plan), exacerbating burdens (incurring extra financial costs, intensifying caregiver responsibilities), and sustaining health through the delay (protecting eligibility, relying on social support, adapting to emerging modalities of care). During the suspension of kidney transplantation programmes, patients felt medically vulnerable because of declining health, susceptibility to infection and reduced access to care. There is a need to address health vulnerabilities, disappointment, uncertainty and additional burdens arising from the suspension of kidney transplantation programmes.
(© 2020 Steunstichting ESOT. Published by John Wiley & Sons Ltd.)

Transpl Int. 2020 Sep;33(9):1142-1143. (PMID: 32386444)
Kidney Int. 2020 Jun;97(6):1076-1082. (PMID: 32354637)
Am J Transplant. 2020 Jul;20(7):1809-1818. (PMID: 32282982)
Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
Am J Transplant. 2020 Jul;20(7):1773-1779. (PMID: 32202064)
Lancet. 2020 Mar 14;395(10227):912-920. (PMID: 32112714)
Transplantation. 2020 Jul;104(7):1316-1320. (PMID: 32569002)
Transpl Int. 2020 Sep;33(9):1040-1045. (PMID: 32357275)
Transpl Immunol. 2020 Aug;61:101304. (PMID: 32371150)
N Engl J Med. 2020 Jun 18;382(25):2475-2477. (PMID: 32329975)
Transpl Int. 2020 Sep;33(9):1099-1105. (PMID: 32460390)
Kidney Int. 2020 Jun;97(6):1083-1088. (PMID: 32354634)
Am J Transplant. 2020 Sep;20(9):2332-2336. (PMID: 32282992)
Lancet Respir Med. 2020 May;8(5):e39. (PMID: 32305079)
Transpl Int. 2020 Sep;33(9):1151-1153. (PMID: 32460385)

The University of Sydney Robinson Fellowship; ID1190850 NHMRC Postgraduate Scholarship; Royal Prince Alfred Hospital

Keywords: COVID-19; coronavirus; patient-centred care

Date Created: 20200709 Date Completed: 20210308 Latest Revision: 20220731

20221213

PMC7361590

10.1111/tri.13697

32640048