Speaker: Increasing transparency during the transplant process can increase access
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SCOTTSDALE, Ariz. — Providers can help increase patients’ odds of access to transplant by being transparent about candidate standards for application, according to a presenter at the Cutting Edge of Transplantation Summit.
“There's a famous quote in management that says, ‘Every system is perfectly designed to achieve exactly the results that it gets,’” Keren Ladin, PhD, MPH, from Emory University, said in the presentation. “If we think about disparities in transplantation being described for decades now, this should beg the question: How should we redesign the transparent system to achieve a different or more equitable outcome?”
One of the areas in which transplantation could be reimagined is in the evaluation process. Ladin noted that subjective criteria required to be an “ideal candidate” lack standards and are often applied inconsistently. Further, transplant centers are not always transparent to patients about the evaluation criteria and the standards are not always evidence based, she said.
“You should know when you go to a center, how you might be evaluated and your likelihood there of being listed,” Ladin said.
Determining factors can include social support, and sometimes patients without a caregiver can be passed on as a transplant candidate. Ladin referenced research into social support as evidence-based criteria, and results revealed neither social support nor marital status predicted medication adherence or post-transplant outcomes.
Therefore, Ladin suggested that criteria used to judge candidates be evidence-based and void of implicit bias. Once the standards are revised, these can be transparent to candidates so that they can prepare for the evaluation and have a better chance of listing.
“We can make this information public. We can allow patients to choose between centers if they know and understand what their likelihood of being listed is and the care that they'll receive at each center,” Ladin said.
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