UCSF

Purpose: The disparity between kidney donor supply and demand remains a critical challenge, with living donor kidney transplantation playing a key role in addressing the organ shortage. Most patients need support in searching for living donors. At our academic medical center, since 2021 the kidney transplant team is deploying pre-health students as kidney transplant navigator interns. Eighty percent of students in the program are from underrepresented populations, thereby extending the cultural and linguistic competency of the workforce. Accordingly, students focus on helping patients from underserved populations. Methods: We identified the number of consecutive patients seeing 6 participating nephrologists for evaluation appointments between 8/27/23 and 11/20/24. We assessed how many of these received support from a student navigator, how many found living donors, and how many received transplants. For an exploratory comparison, we assessed how many patients receiving usual care from a non-participating nephrologist found living donors and received transplants. Results: Out of 835 consecutive patients scheduled for evaluation by 6 attending nephrologists for kidney transplantation, student navigators supported 386 (46%). The mean number of navigator-patient interactions was 4.28 (range 1 to 14). Over time, the transplant team designated 278 of the 386 student-supported patients (72%) as eligible to receive a kidney transplant. Of the 278 supported and eligible patients, within our monitoring time frame, 52 (19%) found potential living donors who qualified after health checks. Two of these 52 actually received living donor transplants. Patients frequently expressed appreciation for the student support. Attending nephrologists also endorsed the student navigation efforts as beneficial. In our usual care comparison group of 143 patients scheduled for evaluation with a non-participating nephrologist, 108 were eligible for transplant, 17 (16%) found living donors, and 1 had a transplant. Conclusions: Our program successfully deployed students to extend the kidney transplantation workforce. A slightly higher proportion of patients in our student-supported cohort registered living donors than in our usual care comparison group. We are strengthening our support intervention and plan to continuously improve from this baseline. Student support for patients frees up providers and staff to “practice at the top of their license." In addition, underrepresented students gain experience and advance in the pipeline to health careers. Institutional leaders also see the program as advancing key strategic goals related to performing as a learning health system and delivering culturally congruent care. Future directions include more robust evaluations over longer time periods.