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Patzer RE, Smith K, Basu M, et al. The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity. Kidney Int Rep. 2017;2(3):433-441doi: 10.1016/j.ekir.2017.02.002.
Patzer, R. E., Smith, K., Basu, M., Gander, J., Mohan, S., Escoffery, C., Plantinga, L., Melanson, T., Kalloo, S., Green, G., Berlin, A., Renville, G., Browne, T., Turgeon, N., Caponi, S., Zhang, R., & Pastan, S. (2017). The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity. Kidney international reports, 2(3), 433-441. https://doi.org/10.1016/j.ekir.2017.02.002
Patzer, Rachel E, et al. "The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity." Kidney international reports vol. 2,3 (2017): 433-441. doi: https://doi.org/10.1016/j.ekir.2017.02.002
Patzer RE, Smith K, Basu M, Gander J, Mohan S, Escoffery C, Plantinga L, Melanson T, Kalloo S, Green G, Berlin A, Renville G, Browne T, Turgeon N, Caponi S, Zhang R, Pastan S. The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity. Kidney Int Rep. 2017 May;2(3):433-441. doi: 10.1016/j.ekir.2017.02.002. Epub 2017 Feb 09. PMID: 28845470; PMCID: PMC5568836.
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Kidney Int Rep. 2017 May;2(3):433-441. doi: 10.1016/j.ekir.2017.02.002. Epub 2017 Feb 09.

The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity.

Kidney international reports

Rachel E Patzer, Kayla Smith, Mohua Basu, Jennifer Gander, Sumit Mohan, Cam Escoffery, Laura Plantinga, Taylor Melanson, Sean Kalloo, Gary Green, Alex Berlin, Gary Renville, Teri Browne, Nicole Turgeon, Susan Caponi, Rebecca Zhang, Stephen Pastan

Affiliations

  1. Department of Surgery, Division of Transplantation, Emory University School of Medicine, 101 Woodruff Circle, 5101 Woodruff Memorial Research Building, Atlanta, GA 30322.
  2. Department of Epidemiology, Rollins School of Public Health, Emory University School of Medicine 1518 Clifton Road Atlanta, GA 30322.
  3. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322.
  4. Department of Medicine, Division of Nephrology, College of Physicians & Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, 622 West 169th Street, New York, NY 10032.
  5. Department of Medicine, Division of Renal Medicine, Emory University School of Medicine, 101 Woodruff Circle, 5101 Woodruff Memorial Research Building, Atlanta, GA 30322.
  6. Department of Health Policy Management, Rollins School of Public Health, Emory School of Medicine, 1518 Clifton Road, Atlanta, GA 30322.
  7. American Association of Kidney Patients, 2701 N. Rocky Point Drive, Suite 150, Tampa, FL 33607.
  8. Southeastern Kidney Transplant Coalition, Atlanta, GA 30322.
  9. National Kidney Foundation, 270 Peachtree St NE #1040, Atlanta, GA 30303.
  10. University of South Carolina, College of Social Work, 902 Sumter Street, Columbia, SC 29208.
  11. US ESRD Network 2, 1979 Marcus Ave, Lake Success, NY 11042.
  12. Department of Biostatistics, Rollins School of Public Health, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322.

PMID: 28845470 PMCID: PMC5568836 DOI: 10.1016/j.ekir.2017.02.002

Abstract

INTRODUCTION: The United Network for Organ Sharing (UNOS) implemented a new Kidney Allocation System (KAS) in December 2014 that is expected to substantially reduce racial disparities in kidney transplantation among waitlisted patients. However, not all dialysis facility clinical providers and end stage renal disease (ESRD) patients are aware of how the policy change could improve access to transplant.

METHODS: We describe the ASCENT (Allocation System Changes for Equity in KidNey Transplantation) study, a randomized controlled effectiveness-implementation study designed to test the effectiveness of a multicomponent intervention to improve access to the early steps of kidney transplantation among dialysis facilities across the United States. The multicomponent intervention consists of an educational webinar for dialysis medical directors, an educational video for patients and an educational video for dialysis staff, and a dialysis-facility specific transplant performance feedback report. Materials will be developed by a multidisciplinary dissemination advisory board and will undergo formative testing in dialysis facilities across the United States.

RESULTS: This study is estimated to enroll ~600 U.S. dialysis facilities with low waitlisting in all 18 ESRD Networks. The co-primary outcomes include change in waitlisting, and waitlist disparity at 1 year; secondary outcomes include changes in facility medical director knowledge about KAS, staff training regarding KAS, patient education regarding transplant, and a medical director's intent to refer patients for transplant evaluation.

CONCLUSION: The results from the ASCENT study will demonstrate the feasibility and effectiveness of a multicomponent intervention designed to increase access to the deceased-donor kidney waitlist and reduce racial disparities in waitlisting.

Keywords: ESRD Networks; Kidney Allocation System; education; kidney transplant; multicomponent intervention; waitlisting

Conflict of interest statement

Author Contributions R.E.P participated in study design, intervention development, planning for data collection, helped draft the manuscript and is principal investigator. K.D.S. participated in inter

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