How Patients Choose Kidney Transplant Centers: A Qualitative Study of Patient Experiences.

Little is known about how patients make the critical decision of choosing a transplant center. In the US, acceptance criteria, waiting times and mortality vary significantly by geography and center. We sought to understand patients' experiences and perspectives when selecting transplant centers. We included 82 kidney transplant patients in 20 semi-structured interviews, 9 focus groups with local candidates, and 3 focus groups with national recipients. Sites included 2 local transplant centers in Minneapolis, Minnesota, and national recipients from across the US. Transcripts were analyzed by 2 researchers using a thematic analysis. Several themes emerged related to priorities and barriers when choosing a center. Patients were often unfamiliar with options, even with multiple local centers. Patients described being referred to a specific center by a trusted provider. Patients prioritized perceived reputation, comfort, and convenience. Insurance coverage was both a source of information and a barrier to options. Patients underestimated differences across centers and the effects on being waitlisted and receiving a transplant. Barriers in decision making included an overwhelming scope of information and difficulty locating information relevant to patients with unique medical needs. Informed decisions could be improved by the dissemination of understandable information better tailored to individual patient needs. This article is protected by copyright. All rights reserved.