Table 3.
Factors to consider for transplant evaluation of a patient who is unlikely to outlive the graft, 65 years or older, frail, or cognitively impaired
| % of experts who rated the factor after two rounds as very important or important to consider when listing a KT candidate for transplantation who is: | ||||
|---|---|---|---|---|
| Factor | Unlikely to outlive the graft | Aged ≥65 years | Frail | Cognitively impaired |
| Health Related Quality of Life (HRQOL) | 95% | 95% | 85% | 95% |
| Social Support | 50% | 100% | 95% | 100% |
| Medication adherence | *** | 100% | *** | 95% |
| Low or no frailty* | *** | 95% | *** | *** |
| Younger Age | 85% | * | 90% | 70% |
| Good functional status* | *** | 100% | *** | *** |
| Benefit over dialysis to patient* | 75% | *** | *** | *** |
| Low comorbidity burden* | *** | 80% | *** | *** |
| No medical contraindications* | *** | 95% | 90% | *** |
| Symptoms on dialysis | 60% | *** | 35% | *** |
| Dependence in activities of daily living | 40% | 35% | ** | ** |
| Race/Ethnicity | ** | ** | ** | ** |
| Sex | ** | ** | ** | ** |
| Frailty could be reversible or improved (from transplant or prehab) | *** | *** | 95% | *** |
| Likelihood for success or benefit from surgery | *** | *** | 95% | *** |
| Degree of cognitive impairment (e.g., mild vs. dementia) | *** | *** | *** | 95% |
| Cognitive impairment related to ESRD/HD symptoms and not a primary neurocognitive disorder | *** | *** | *** | 75% |
*New factor that was suggested by ≥2 experts in round 1, then subsequently included in round 2
** Experts were not asked to rate factors in round 2 that were rated very important/important by < 25% in round 1
*** Factor not relevant to this patient