Abstract
Background
Transplant failure is associated with increased morbidity, mortality and poor quality of life. There is limited evidence to inform treatment decision-making when and after kidney transplants fail: randomised controlled trials are needed. We investigated the feasibility and acceptability of clinical trials into the management of kidney transplant failure, and explored research facilitators and barriers.
Methods
We undertook in-depth interviews with adults (aged ≥ 18 years) who had failing kidney transplants or had experienced kidney transplant failure, their relatives/friends, and healthcare professionals (HCPs). Participants were recruited from three UK NHS hospitals. Iterative purposive sampling of patient participants was undertaken, aiming for diversity with respect to personal characteristics, the type of transplant received (living/deceased-donor), whether the transplant was failing or had failed, and current kidney disease treatment. Purposive sampling of HCPs ensured diversity in sex, age, ethnicity, and role. Family and friends were recruited via posters and snowball sampling. Interviews investigated perspectives on clinical trials at the time of transplant failure. Sample size was determined by reaching theoretical saturation. We undertook inductive analysis according to constructivist grounded theory.
Results
Forty-one participants (17 HCPs/15 patients/9 relatives or friends) were interviewed. We identified the following categories:
Transplant failure is associated with increased morbidity, mortality and poor quality of life. There is limited evidence to inform treatment decision-making when and after kidney transplants fail: randomised controlled trials are needed. We investigated the feasibility and acceptability of clinical trials into the management of kidney transplant failure, and explored research facilitators and barriers.
Methods
We undertook in-depth interviews with adults (aged ≥ 18 years) who had failing kidney transplants or had experienced kidney transplant failure, their relatives/friends, and healthcare professionals (HCPs). Participants were recruited from three UK NHS hospitals. Iterative purposive sampling of patient participants was undertaken, aiming for diversity with respect to personal characteristics, the type of transplant received (living/deceased-donor), whether the transplant was failing or had failed, and current kidney disease treatment. Purposive sampling of HCPs ensured diversity in sex, age, ethnicity, and role. Family and friends were recruited via posters and snowball sampling. Interviews investigated perspectives on clinical trials at the time of transplant failure. Sample size was determined by reaching theoretical saturation. We undertook inductive analysis according to constructivist grounded theory.
Results
Forty-one participants (17 HCPs/15 patients/9 relatives or friends) were interviewed. We identified the following categories:
| Original language | English |
|---|---|
| Journal | Trials |
| Early online date | 11 May 2026 |
| DOIs | |
| Publication status | E-pub ahead of print - 11 May 2026 |
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