Marie-Chantal Fortin's research while affiliated with Centre hospitalier de l'Université de Montréal (CHUM) and other places

Publications (18)

Article
Full-text available
Introduction Studying existing health systems with variable living donor kidney transplantation (LDKT) performance and understanding factors that drive these differences can inform comprehensive system-level approaches to improve LDKT. We aimed to quantify previously identified barriers and estimate their association with LDKT performance. Methods...
Article
Background: In patients with kidney failure, living donor kidney transplantation (LDKT) is the best treatment option; yet, LDKT rates have stagnated in Canada and vary widely across provinces. We aimed to identify barriers and facilitators to LDKT in a high-performing health system. Methods: This study was conducted using a qualitative explorato...
Chapter
Living donor kidney transplantation (LDKT) is an important strategy for treating end-stage kidney disease, alongside dialysis and deceased donor transplantation. LDKT can benefit recipients and other patients waiting for a donated kidney. The relationships among transplant programs, donor candidates, and LDKT recipients, however, do not neatly map...
Article
Full-text available
Purpose of review To review an international guideline on the evaluation and care of living kidney donors and provide a commentary on the applicability of the recommendations to the Canadian donor population. Sources of information We reviewed the 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation...
Article
Résumé Depuis décembre 2015, l’aide médicale à mourir, une pratique au centre de nombreux débats éthiques, est légalisée dans la province du Québec, au Canada. Ce nouveau type de décès a créé un tout nouveau contexte pour le don d’organes, soit le don d’organes après l’aide médicale à mourir. Le prélèvement des organes s’effectue alors suivant le p...
Article
Full-text available
Purpose of Review Living-donor kidney transplantation (LDKT) offers the best medical outcomes in terms of graft and patient survival for end-stage renal disease (ESRD) patients. LDKT involves a medically and psychologically suitable individual willingly agreeing to donate a kidney to a loved one or stranger. It is a unique situation in which a heal...
Article
Optimal adherence to immunosuppressive medication is essential to kidney graft success. Transplant-TAVIE is a Web-based tailored virtual nursing intervention developed to promote medication adherence and support self-management among kidney transplant recipients. A qualitative study was undertaken in a hospital setting in Montreal (Canada) to docum...
Article
Full-text available
Background Living donor kidney transplantation (LDKT) has several advantages over deceased donor kidney transplantation. Yet rates of living donation are declining in Canada and there exists significant interprovincial variability. Efforts to improve living donation tend to focus on the patient and barriers identified at their level, such as not kn...
Data
Supplementary_Appendix_1_Codebook-LDKT – Supplemental material for Health Professional–Identified Barriers to Living Donor Kidney Transplantation: A Qualitative Study
Article
Full-text available
Purpose Clinical researchers are now encouraged to include patient partners in all research projects. Nevertheless, published accounts of patient engagement in complex research projects, such as those involving critically ill and dying patients, are lacking. Whether this absence is due to the relatively new emergence of patient engagement research...
Article
Full-text available
Background Optimal immunosuppressive medication adherence is essential to graft survival. Transplant-TAVIE is a Web-based tailored intervention developed to promote this adherence. Objective The objective of our study was to evaluate the Transplant-TAVIE intervention’s acceptability, feasibility, and preliminary efficacy. Methods In a pilot, para...
Article
In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many impli...
Chapter
The provision of medical care, and particularly organ transplantation, to foreign nationals (i.e. non-citizens and non-residents) is a matter of heated debate in many countries. Worldwide, the practices regarding the provision of transplantation services to foreign nationals vary enormously. Developed countries with transplant programs often receiv...

Citations

... However, the provision of services is under provincial mandates, which has led to real-life differences in LDKT performance. 16 The national living donor rates averages around 15 donors/million population annually, however, these rates range from 6 to 23 living donors/million population across provinces. 17-20 Some provinces have consistently outperformed the national average, while others have had consistently lower rates. ...
... However, current, often unidimensional, approaches to increase LDKT have led to modest improvements and some argue are contributing to disparities in access to LDKT. 1,3,[5][6][7][8][9] Overall, there is growing recognition that efforts to increase LDKT should include a comprehensive system-level approach to understanding and addressing barriers and inefficiencies that patients and their donors face. 1,2,[10][11][12][13][14][15] Investigating current health systems with variable LDKT rates and understanding factors that drive these differences may provide rich insights into these system-level barriers and inefficiencies. ...
... 20 As the 1-year allograft and short-term survival after kidney transplant improves, using these parameters to evaluate the quality of a transplant program is becoming obsolete. 36 Schold and colleagues 37 have urged for reform in kidney transplant quality metrics. Recently, a multiphase framework encompassing a broad range of kidney transplant quality indicators, including timely and equitable access and efficiency measures, has been proposed. ...
... Four guidelines and two consensus statements recommended enquiring into previous pregnancy complications during the assessment of a potential LKD.31,32,35,40,41 Six guidelines recommended informing the potential LKD of the increased risk of post-donation pregnancy complications.31,[33][34][35][36][37] One consensus statement suggested that alternative donors should be sought for women who had not completed their family and had a history of pre-eclampsia.40 ...
... "Patient perception" refers to the "perception of the interaction related to use of a telemedicine service" [22] or to "patient perceptions of the virtual rounding experience" [32]. In six articles, the terms are used in parallel with various meanings [21,22,28,31,32,34] and two articles even equate the terms UX and PX [37,38]. ...
... Several studies have used qualitative approaches to identify possible barriers to kidney donation. These studies have identified several factors that can contribute to decision-making for both living and deceased donation, including the social influence of health care professionals (HCPs) [10], family members [11], and recipients and potential donors [12,13], as well as medical [14] and financial [15,16] barriers. Other factors are related to beliefs and concepts, such as unknown future needs [17] (ie, "What if my family member needs a donation someday?"), a desire for bodily integrity and choice, trust or mistrust of the health care system, religious and cultural beliefs, and a lack of information about donation [10]. ...
... Our experience with this study is positive because, despite the delicate topics to be discussed, the willingness to participate was good and the families understood the need for the research to learn about their experiences and improve the unfavorable aspects of it, as a previous study concluded. (24) These results can help to develop support and monitoring programs for donor families. In addition, transplant organizations can organize educational programs where donor family members participate by sharing their testimonies with other families. ...
... All included studies were written in English. Roughly two-thirds of the RCTs were conducted in four countries: the USA (n = 8, 35%) [45][46][47][48][49][50][51][52], Canada (n = 3, 13%) [53][54][55], South Korea (n = 3, 13%) [56][57][58] and Brazil (n = 2, 9%) [59,60]. One study each was performed in Australia [61], Belgium [62], Denmark [63], France [64], Germany [65] and Sweden [66]. ...
... To safeguard autonomy, many jurisdictions prohibit or discourage OPO/physician-initiated DCDD consent approaches or directed donation with ODE. [268][269][270]354,370,[379][380][381] Safeguarding end-of-life experience for MAiD patients in the ODE context requires active monitoring, given the potential for changes to the benefit/harm balance with these, sick, vulnerable patients, unlike unconscious withdrawal-of-life-sustaining-therapy patients. Examples include: burdensome assessments during their final days of life, painful interventions, the presence of unknown healthcare teams during MAiD, a different setting for MAiD and changes to the family's experience and bereavement due to removal of the body for several hours. ...
... 1 Various arguments are used to support or oppose organ transplantation for FNs, such as justice, reciprocity, and physicians' duties toward vulnerable populations. [2][3][4][5][6] It is beyond the scope of this article to review these arguments in detail. ...