Abstract
Looking over publications in this issue, it is apparent that education prior to transplantation is a growing topic of study. Provider identified barriers to delivering education was the focus of a qualitative study by Dolph, et al. Time and knowledge were key barriers identified. Paired donation in and of itself is complex and we have 2 studies that assess the impact of education needs and psychological impact of undergoing paired donation. Deciding what content on the process needs to be provided was the focus of the mixed methods study by Pines, et al. From the interviews, donor and recipients requested to learn more about donor protections and failed exchanges. Bourkas, et al interviewed recipients who underwent paired kidney donation and discovered recipients often have feelings of guilt and worry about their donor.
Morinelli, et al tested a video-based intervention that showed an increase in knowledge, suggesting not all education needs to be provided by face-to-face interactions. Jesse, et al tested a face-to-face specialized clinic that provided enhanced education and eligibility support. Using this novel clinic setting, the investigators were able to improve biological outcomes and reduce early readmissions. It’s great to see that investigators are testing novel ways to improve translating knowledge into behavior. As we all know changing behavior is difficult and does not rely solely on knowledge.
Oral disease burden, posttransplant diabetes, and urinary tract infections, topics of common interest after transplantation are also included within this issue. One topic not frequently seen in the literature is waitlist deactivation decision-making by providers and the perception of deactivation on parents. It was interesting to see that providers and families tended to agree on the reasons for deactivation and the factors that were important to achieve to be listed for transplantation.
A systematic review of employment studies to assess rates and characterize factors for employment after thoracic transplantation was undertaken by Kugler, et al. In this review, the investigators found younger age, employment pretransplant and educational level positively associated with posttransplant employment. What type of interventions can transplant centers use to help patients back into the workforce?
This issue provides you with a variety of articles on topics that clinicians may find useful. I challenge clinicians to consider what interventions are needed in your own facility that will improve clinical outcomes. Seek collaboration with an established investigator to trial your interventions. For investigators, it is time to move beyond descriptive and comparative research and test interventions. Seeking funding is always an issue, but small trials to pilot an intervention can jumpstart your program of research into the funded interventional arena.