Kidney Transplants in the Internet Age

Kidney donor screening is quicker and easier using online tools

(RxWiki News) Across the United States, hundreds of thousands of dialysis patients are waiting for new kidneys. Unfortunately, there are not enough organs to go around. Paperless donor screening may partially fix this problem.

Using web-based tools to screen potential kidney donors led to a large boost in donor applications at two U.S. transplant centers.

The paperless format makes the screening process easier, allowing transplant centers to screen a larger number of people in a shorter amount of time.

"Register as an organ donor today!"

The University of California, San Francisco (UCSF) and Vanderbilt University have reported substantial increases in potential kidney donors since adopting the web-based system.

"We're having to redo some of our workflow because we're getting so many potential donors," John Roberts, M.D., Chief of Transplantation at UCSF, told Renal & Urology News. "For example, one of the people on our transplant wait list has 19 potential donors."

He adds, "It's much more unlikely to get multiple potential donors stepping forward when the screening questionnaire is on paper. That's why we're really excited about online screening."

In the past, transplant centers used paper-based forms and in-person meetings to assess whether a person was a suitable organ donor. This process was not only inefficient, but also expensive.

With these new online screening tools, potential donors only have to give a few minutes of their day to answer questions about their medical history. They provide information on hypertension, diabetes, kidney problems, smoking habits, and drug use among other things.

“Of the 113,000 patients awaiting a life-saving transplant in this country, 90,000 are in need of kidneys," says Michelle Segovia of the Texas Organ Sharing Alliance. "Since most people are born with two kidneys, a person can potentially donate one to a friend or family member in need. Of course the potential living donor would undergo extensive medical testing prior to donating but the web-based screening could streamline the initial process in which the person is evaluated for donor eligibility.”

Since adopting the web-based system (called Breeze and supplied by MedSleuth, Inc.), the UCSF Medical Center has had a 40 percent increase in the number of potential donor applications, said Dr. Roberts in an article in Healthcare Informatics.

"It has really streamlined the process of getting donors through the initial step of entering the system, knowing they could potentially donate if they are otherwise healthy," said Dr. Roberts in the Healthcare Informatics article.

According to MedSleuth, most transplant centers use an evaluation system that increases the risk of complications, increases healthcare costs, and lowers patient satisfaction.

The Breeze system is designed to address these shortcomings and help transplant centers and community based caregivers improve patient health and survival of transplanted organs; comply with the mandates of the United Network for Organ Sharing and Centers for Medicare and Medicaid Services; reduce the high costs of evaluating patients for transplant eligibility.

The transplant center at Vanderbilt University uses its own - albeit similar - web-based kidney donor application process.

"We are very excited about this new web-based tool and feel that it can be easily incorporated into many transplant programs," Deonna Moore, M.S.N., a nurse practitioner at Vanderbilt, told Renal & Urology News. "The features of the web-based application increase the transplant center's ability to attract donors and process them efficiently, with the ultimate goal being to potentially increase living kidney donation."

The transplant programs at both UCSF and Vanderbilt have found that about a quarter of the people who are screened online do not fit the requirements for being a donor. Because these applicants never had to go through an extensive process involving paper-based applications and face-to-face meetings, the transplant centers are saving substantial amounts of money.

The web-based systems also may help transplant centers decide who might be the best transplant recipients. "The algorithm can help us evaluate and collect information on the kidney transplant patient, so when he comes in for his first evaluation appointment, we can direct our conversation with the patient about the specific disease," said Dr. Roberts. "Having that collected information with a summary up front would help us."

At the moment, the system is mainly used for potential kidney donors. Dr. Roberts told Healthcare Informatics that the system could be adjusted to work for liver transplants.

"I would hope that we would have the same surge in the number of people who are interested in donating," he says.

Only a handful of transplant centers around the United States have implemented web-based screening tools. In the coming years, as more centers adopt these tools, we may gain a better idea of how online screening improves the transplant process.

Review Date: 
January 31, 2012