Access to Kidney Transplantation in Minority Populations (AKT-MP)

  • STATUS
    Recruiting
  • End date
    Nov 21, 2025
  • participants needed
    398
  • sponsor
    University of New Mexico
Updated on 21 March 2022
kidney transplant

Summary

Hispanic/Latino (HL) and American Indian (AI) patients are more likely than whites to have kidney failure, but less likely to complete transplant evaluation or receive a kidney transplant (KT), the best treatment for kidney failure. Using comparative effectiveness research methods, we will conduct a pragmatic randomized trial to compare the efficacy and cost- effectiveness of two approaches to help HL and AI patients overcome barriers to completing transplant evaluation and receiving a KT: a streamlined KT evaluation process and a peer-assisted evaluation program; and, we will determine best practices to assist other transplant centers in implementing the better program. Findings from this work may help reduce disparities in transplant evaluation and KT.

Description

The AKT-MP study will assess whether Kidney Transplant Fast Track (KTFT), a streamlined KT evaluation process, or peer navigators (PN) who were former KT patients to help patients "navigate" their way through KT evaluation, can help vulnerable patients with kidney failure overcome barriers to transplant listing. After culturally and contextually adapting the two interventions, we will use a comparative effectiveness (CER) approach to conduct a pragmatic randomized trial of 398 kidney failure patients to compare the efficacy and effectiveness of the two approaches in disadvantaged groups at a university-affiliated transplant center with large HL and AI kidney failure patient populations, and we will compare results to historic comparison populations (local and national). We will assess facilitators and barriers to widespread implementation and conduct a cost effectiveness analysis. Although it is expected that KTFT will be more effective than PN, KTFT may also be more costly, requiring significant administrative and clinical changes in the transplant center, which may be impractical to maintain. Further, KTFT may lead to more patient ambivalence because the shortened evaluation period will give them less time to consider their treatment options. Thus, an important aspect of the proposed study is to comparative the effectiveness of the two methods. Ultimately, our study will inform transplant programs faced with disparities in KT about which disparity-reducing intervention to use given their particular needs and resources.

Details
Condition Kidney Diseases
Treatment Kidney Transplant Fast Track (KTFT), Peer Navigation (PN)
Clinical Study IdentifierNCT04615819
SponsorUniversity of New Mexico
Last Modified on21 March 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Undergoing kidney transplant evaluation at the University of New Mexico
Greater than or equal to 18 years of age
Mentally competent

Exclusion Criteria

Children less than 18 years of age are excluded because all research-related measurements are designed for patients over the age of 18. Children less than 18 years of age have dissimilar decision-making authority as a result of their developmental stage and dependency on adult guardians who must make all their transplant-related decisions, as required by all pediatric transplant centers. The proposed study focuses only on adult transplant patients
Waitlisted at another transplant center
Prior kidney transplant
Incarcerated patients
Pregnant women
Active systemic infection
Non-skin malignancy or melanoma in the past 2 years
Known cognitive impairment
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