Electronic messaging and communication with living kidney donors

New regulations require living kidney donor (LKD) follow-up for two years, but donor retention remains poor. Electronic communication (e.g. text messaging, e-mail) might improve donor retention. To explore the possible impact of electronic communication, we recruited LKDs to participate in an exploratory study of communication via telephone, e-mail, or text messaging post-donation; communication through this study was purely optional and did not replace standard follow-up. Of 69 LKDs recruited, 3% requested telephone call, 52% e-mail, and 45% text messaging. Telephone response rate was 0%; these LKDs were subsequently excluded from analysis. Overall response rates with email or text messaging at 1-week, 1-month, 6-months, 1-year, and 2-years were 94%, 87%, 81%, 72%, and 72%. Lower response rates were seen in African Americans, even after adjusting for age, sex, and contact method (incidence rate ratio (IRR) nonresponse 2.075.8116.36, p=0.001). Text messaging had higher response rates than email (incidence rate ratio (IRR) nonresponse 0.110.280.71, p=0.007). Rates of nonresponse were similar by sex (incidence rate ratio (IRR) 0.68, p=0.4) and age (incidence rate ratio (IRR) 1.00, p>0.9). In summary, LKDs strongly preferred electronic messaging over telephone and were highly responsive two years post-donation, even in this non-required, non-incentivized exploratory research study. These electronic communication tools can be automated and may improve regulatory compliance and post-donation care.