Web-Based Self-Management Guide for Kidney Transplant Recipients (The Getting on With Your Life With a Transplanted Kidney Study): Protocol for Development and Preliminary Testing

Self-Management of Kidney Transplant Recipients Research: A Comprehensive Bibliometric Analysis

Objective

This study analyzes research trends in self-management among kidney transplant recipients to inform future directions.

Methods

Bibliometric analysis was performed on 444 English articles related to self-management of kidney transplant recipients in the Core Collection of Web of Science and Scopus databases using COOC 12.8, R software, Microsoft Excel 2019, VOSviewer, and CiteSpace, with a focus on citation ranking, publication year, journal, country, organization, author, impact factor, and keywords.

Results

Four hundred and forty-four English articles revealed the United States as the leading publisher on kidney transplant recipient self-management. Norway's University of Oslo was the most productive institution, with Mirjam Tielen as the most prolific author and SCHÄFER-KELLER as the most influential. Belgium's research was most cited. Emerging hotspots included medication adherence, quality of life, psychological aspects, telemedicine, and health literacy in self-management research.

Conclusion

This study has identified the most influential articles concerning the self-management of kidney transplant recipients, documented the pivotal journals in the field, and noted the most prolific countries, organizations, and authors contributing to the literature, as well as highlighted upcoming research trends. Going forward, the research in kidney transplant recipient self-management should explore the full potential of interdisciplinary integration, particularly by incorporating telemedicine into self-management education. Future efforts should also be directed towards refining the existing post-transplant follow-up management systems and enhancing lifelong care for kidney transplant recipients. Concurrently, there is a need to improve health literacy and self-management capabilities among these patients, with the ultimate goal of improving their prognosis.

Exploring the relationship between website quality and equity in living donor kidney transplant

Background

Health system websites are important resources to guide health care decisions and may be useful tools to improve racial equity in access to living donor kidney transplant (LDKT).

Methods

We performed a cross-sectional study of adult LDKT programs in the United States. We created an assessment tool for website quality across three domains: accessibility (access to LDKT specific information from the transplant center website), readability (ease of reading and clarity), and educational content (appropriateness and presentation of information, LDKT-specific content, program-specific characteristics, and adherence to equity-centered principles of web design).

Results

Among the 185 transplant center websites reviewed, only 14.6% of LDKT sites could be accessed directly from the transplant center webpage. The median suitability assessment of materials (SAM)-a validated measure of website content for chronic kidney disease (CKD)-was 45 out of 86 (IQR 4) and the median Flesch-Kincaid grade level and ease score were 9.1 (IQR 0.8) on a scale of 0-18 and 51.2 (IQR 5) on a scale of 0-100, respectively.

Conclusion

These results indicate that LDKT websites are currently not available, accessible, and understandable for many potential transplant candidates and donors. Optimizing the content and design of transplant center websites may be a promising and effective strategy for improving equity in access to LDKT.

Mapping Health-Related Quality Of Life After Kidney Transplantation By Group Comparisons: A Systematic Review

Background

Health-related quality of life (HRQOL) is becoming an increasingly important outcome in kidney transplantation (KT). To describe HRQOL in kidney transplant recipients (KTRs), this systematic review summarizes literature that compared HRQOL among KTRs and other relevant populations [i.e. patients receiving dialysis, patients on the waiting list (WL) for KT, patients with chronic kidney disease (CKD) not receiving renal replacement therapy (RRT), the general population (GP) and healthy controls (HCs)] and themselves before KT.

Methods

The literature search was conducted in PubMed, Embase, Web of Science and the Cochrane Library. Eligible studies published between January 2000 and October 2020 were included.

Results

Forty-four studies comprising 6929 KTRs were included in this systematic review. Despite the study heterogeneity, KTRs reported a higher HRQOL after KT compared with pre-transplantation and compared with patients receiving dialysis with or without being on the WL, especially in disease-specific domains (i.e. burden and effects of kidney disease). Additionally, KTRs had similar to marginally higher HRQOL compared with patients with CKD Stages 3–5 not receiving RRT. When compared with HCs or the GP, KTRs reported similar HRQOL in the first 1 or 2 years after KT and lower physical HRQOL and lower to comparable mental HRQOL in studies with longer post-transplant time.

Conclusions

The available evidence suggests that HRQOL improves after KT and can be restored to but not always maintained at pre-CKD HRQOL levels. Future studies investigating intervention targets to improve or maintain post-transplant HRQOL are needed.