The Role of Telemedicine in Kidney Transplantation: Opportunities and Challenges

Kidney transplantation is the treatment of choice for patients with advanced kidney disease who are medically and surgically fit to undergo the procedure and have reasonable life expectancy. It provides improved survival and quality of life for recipients and overall cost savings to the health care system (1,2). The process of undergoing kidney transplantation involves several phases of care including pretransplant referral and evaluation, waitlist management, and follow-up. In all phases of care, transplant centers interface with candidates and recipients who live across a wide geographic range, with many patients traveling significant distances to a transplant center (3). In the United States, 41,077 candidates were added to the waiting list in 2019 and 23,401 received a transplant. There are approximately 220,000 prevalent kidney transplant recipients and 250 centers actively performing kidney transplants (4). With this continually growing patient population and a limited number of transplant providers, transplant centers are in need of innovative models of health care delivery that ( 1 ) allow them to reach and monitor candidates and recipients, particularly those that live far away; and ( 2 ) improve utilization of transplant center resources. Telemedicine, the practice of medicine using technology to deliver care at a distance, represents an opportunity to do both. The technology used may include telehealth videoconferencing (TVC), the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communication (5). Although telemedicine has been successfully used by numerous specialties, its utilization in the field of kidney transplantation has been lagging. Telemedicine has the potential to affect and improve the delivery of kidney transplant care through the following: ( 1 ) replacing or supplementing in-person visits with virtual visits through TVC, ( 2 ) electronic consultation, and ( 3 ) remote monitoring and provision of education through mobile technology (6). Here we focus on TVC and highlight opportunities for its use …