{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:36:08Z","timestamp":1790868968733,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK139339"],"award-info":[{"award-number":["R01DK139339"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>We conducted a national survey to assess the opinions and experiences of transplant center staff related to processes of care graduation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Following IRB approval, medical staff at U.S. adult kidney transplant programs were surveyed using the Qualtrics survey platform (4\/5\/2022\u201310\/05\/2022). Respondents were invited via email and listservs of professional societies. If &gt; 1 survey was submitted for a program, a selection hierarchy was utilized (e.g., prioritizing nephrologists\u2019 responses).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Respondents provided data from 46.7% of active programs (<jats:italic>N<\/jats:italic> = 92), representing 67% of the national kidney transplant volume. Most respondents (70%) were nephrologists. Full graduation to referring nephrologists was reported by 39% of transplant programs, with an additional 48% reporting partial graduation with ongoing co\u2010management. Rationales for graduation were multifactorial, most commonly including patient travel distance (64%), maintenance of referral base (58%), continuity of care (58%), and center and\/or patient burden (54%). Common reasons cited by programs for postgraduation return of care to the transplant center included worsening renal function (82%), malignancy (66%), opportunistic infection (63%), limited local nephrologist availability (60%), and pregnancy planning (57%). Additional coordinators and clinic staff were cited as needed to make transplant center perpetual care feasible by 78% of programs, with 71% stating that more clinicians are needed, while half thought more physical space or telemedicine are required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Graduation of kidney transplant patients is common, with half of programs using a joint\u2010care approach and another third reporting full return of care to the referring nephrologist. Expanded opportunities related to transplant care for the broad nephrology community are essential.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15484","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T08:45:49Z","timestamp":1731055549000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Transition of Care of Stable Kidney Transplant Patients to Referring Nephrologists: A Survey of U.S. Transplant Program Staff"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7881-2162","authenticated-orcid":false,"given":"Prince Mohan","family":"Anand","sequence":"first","affiliation":[{"name":"Medical University of South Carolina  Lancaster South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7495-3758","authenticated-orcid":false,"given":"Kenneth J.","family":"Woodside","sequence":"additional","affiliation":[{"name":"Gift of Life Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3814-1920","authenticated-orcid":false,"given":"Neeraj","family":"Singh","sequence":"additional","affiliation":[{"name":"Willis\u2010Knighton Health System  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4289-0817","authenticated-orcid":false,"given":"Tarek","family":"Alhamad","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine  Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4783-7775","authenticated-orcid":false,"given":"Roy D.","family":"Bloom","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1919-1970","authenticated-orcid":false,"given":"Gaurav","family":"Gupta","sequence":"additional","affiliation":[{"name":"VCU Health  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9856-0329","authenticated-orcid":false,"given":"Gary","family":"Singer","sequence":"additional","affiliation":[{"name":"Midwest Nephrology Associates  Saint Peters Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2510-1951","authenticated-orcid":false,"given":"Mona","family":"Doshi","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7973-1521","authenticated-orcid":false,"given":"Darshana M.","family":"Dadhania","sequence":"additional","affiliation":[{"name":"NYP\u2010Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-9302","authenticated-orcid":false,"given":"Bekir","family":"Tanriover","sequence":"additional","affiliation":[{"name":"University of Arizona  Tuscon Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9243-1582","authenticated-orcid":false,"given":"Ronald F.","family":"Parsons","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Wagner","sequence":"additional","affiliation":[{"name":"Saint Louis University Transplant Center SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiling","family":"Xiao","sequence":"additional","affiliation":[{"name":"Saint Louis University Transplant Center SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-4849","authenticated-orcid":false,"given":"Krista L.","family":"Lentine","sequence":"additional","affiliation":[{"name":"Saint Louis University Transplant Center SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Graduating Kidney Transplant Patients Controversies Workgroup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.01.012"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03490322"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0001172020"},{"key":"e_1_2_10_5_1","unstructured":"Center for Medicare & Medicaid Services (CMS).Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model:A Proposed Rule by the Centers for Medicare & Medicaid Services on 05\/17\/2024 accessed September 23 2024 https:\/\/www.federalregister.gov\/documents\/2024\/05\/17\/2024\u201009989\/medicare\u2010program\u2010alternative\u2010payment\u2010model\u2010updates\u2010and\u2010the\u2010increasing\u2010organ\u2010transplant\u2010access\u2010iota."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002072"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13997"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2011.01567.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3718"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2023.11172"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16717"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14064"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0004592020"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.08.017"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05490421"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16995"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-022-00379-w"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14908"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14967"},{"issue":"7","key":"e_1_2_10_20_1","first-page":"e129","article-title":"Indications, Techniques, and Barriers for Pancreas Transplant Biopsy: A Consensus Perspective From a Survey of US Centers","volume":"108","author":"Singh N.","year":"2024","journal-title":"Transplantation"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2022.03.021"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14437"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13763"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0004062022"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13526"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0008392021"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10880821"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2020.05.005"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2023.05.013"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13449"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16523"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2021.10.002"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnc.2023.05.009"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.040891"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12867"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01550220"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000133"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2023.06.011"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000000000000177"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2023.03.008"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13088"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15964"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15951"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.15484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T15:05:13Z","timestamp":1732547113000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.15484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":42,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/ctr.15484"],"URL":"https:\/\/doi.org\/10.1111\/ctr.15484","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15484"}}