Potential Impact of Probabilistic Survival Information on Kidney Accept/Decline Decisions: A Survey of the National Kidney Foundation’s Community

Background. Decisions to accept or decline kidney offers hinge on candidates and clinician’s expectations of post-transplant outcomes. Yes, no study has quantified the impact of information provided to candidates on the willingness to accept a kidney for transplantation. Methods. National Kidney Foundation members who were either waitlisted or had received a kidney transplant were surveyed to quantify the impact of probabilistic post-transplant survival information on acceptance of kidneys offered for transplant. Survey participants were randomly assigned to 3 groups with similar proportions of (self-identified) White, Black, and other race people, age distribution, and whether the participant received a transplant or was waitlisted. Each participant group received a different hypothetical kidney offer with different donor quality (12%, 48%, and 85% kidney donor profile index, respectively). Results. Participants’ responses were recorded first with only 1-y post-transplant survival information and subsequently with 5- and 10-y survival probabilities. Participants’ level of confidence in their responses and factors most important to them when making acceptance decisions were also recorded. With 1-y survival information 79%, 73%, and 55% of participants accepted offers 1, 2, and 3, respectively. With additional 5- and 10-y survival information, the acceptance rates increased to 88%, 86%, and 73% for each of the 3 offers ( P < 0.001). Conclusions. Participants frequently identified the likelihood of the kidney surviving 5 and 10 y as being the most important information in choosing their acceptance decisions.