[Inadequate involvement of nephrologist/dialysis physicians in transplantation: based on the findings of a survey of transplant recipients].

The number of kidney transplantations(KTx) performed annually in Japan remains small even after enactment of the "Organ Transplant" law. One of the reasons for this paucity of KTx might be because most nephrologists or dialysis physicians who provide medical care to potential transplant candidates have little knowledge of KTx and are seldom involved in the care of recipients and donors. The extent to which Japanese physicians participate in KTx has not been well studied. We sent questionnaires to the 212 kidney transplant recipients who have received an allograft at Tokyo Women's Medical University and conducted a survey to examine the extent to which nephrologists or dialysis physicians are involved in KTx. There were 149 recipients, consisting of 95 males and 54 females with an average age of 46.5 years, who responded to the questionnaire. Only 23% of the patients had considered KTx before dialysis access placement. Lack of information on KTx was suspected for this delay in considering KTx. In fact, only 18% of patients were informed about KTx by their nephrologists before starting dialysis and as many as 49% did not receive any information at all. Forty-eight percent of the patients were not provided with the information even on registration for a cadaveric transplant list by their physicians. Only 20% of the patients received some information about KTx through their nephrologists. On the other hand, nearly 100% of patients think it is essential for nephrologists or dialysis physicians to provide information on KTx especially before the initiation on dialysis access. In addition, almost all of the patients would prefer nephrologists or a dialysis physician to participate in the care of transplant patients from the stage of preoperative evaluation through the post-transplant follow-up period. In conclusion, nephrologists or dialysis physicians have not provided information on KTx to their patients appropriately and most of the transplant recipients expect them to participate in KTx. Nephrologists and dialysis physicians need fundamental knowledge about KTx so that they can provide appropriate information to patients with end-stage renal disease.