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feelings of insecurity related to costs.Our study is among the few to use qualitative methods to study kidney transplant recipients within the US context and to examine expectations for the future. Much of the qualitative research about life after a kidney transplant has been conducted through focus groups and interviews, in contrast to in-person surveys. Our study sample was recruited during follow-up visits and included a broad range of patient demographics and times since transplant; it is possible that a wider range of patients participated than those who would have attended more time-intensive focus groups.The study’s limitations should also be considered. In contrast to studies that use interviews and focus groups, the survey was not interactive. As such, we could not ask patients for clarification or for additional detail. We therefore must be particularly careful with interpretation and be aware of a negativity bias. The open-ended questions were asked at the end of the survey; responses may have been influenced by earlier survey questions or survey fatigue. Not all participants responded to the three open-ended questions; 87, 80, and 36% of the participants answered the questions, respectively. The study was conducted at a single center, and it should be noted that the exclusion criteria barred children and patients with non-renal or prior renal transplants from participation, so responses may not fully generalize to the full spectrum of kidney transplant recipients. Patient responses were collected in 2015 and may be less applicable in today’s context. Perspectives, particularly those related to insurance and the cost of post-transplant care, may also not be representative of patient concerns outside of the US. Finally, the counts presented in Table 2 should be viewed cautiously. A lack of response does not imply that the patient agreed or did not agree with a theme.In this follow-on study, we use qualitative methods to analyze the perspectives of kidney transplant recipients about their current experiences and future concerns. Common themes in the responses included improvements in quality of life and health, as well as concerns about remaining healthy, future quality of life, and cost. Further study may be helpful to understand the effects of cost on patient care and experiences. The findings also suggest the need to study whether changes in education and practice could lessen the stress related to uncertainty in transplant outcomes. A better understanding of recipient perceptions based upon insights gained from qualitative studies of recipient experiences may lead to improvements in pre-transplant education and in post-transplant care.