Dear Dr. Billany,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Reviewers were overall satisfied of the contribution, there are some minor suggestions to implement and reflect upon. As Editor I do agree that it could be nice to at least reflect in the text about these minor points from the Reviewers:

- Clarity on clinical implications – Suggest, in the final discussion, how the findings can be translated into concrete recommendations for home-based rehabilitation programs in different healthcare systems.

- Qualitative data – Although the justification for not making full transcripts available is valid, the authors could strengthen transparency by highlighting criteria for theoretical saturation and providing additional examples in the supplementary material.

- Generalizability – More clearly acknowledge that the findings may reflect a group already motivated to exercise, and that applicability to less engaged recipients still needs to be tested

- Adding more objective measures is highly recommended please add this to your recommendations, and also longer follow up period.

Please submit your revised manuscript by Nov 16 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Simone Borsci, Ph.D.

Academic Editor

PLOS ONE

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When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match.

When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section.

3. Thank you for stating the following financial disclosure:

“ Kidney Research UK”

Please state what role the funders took in the study.  If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

If this statement is not correct you must amend it as needed.

Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf.

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“Feasibility results (previously published) are provided within the manuscript to provide the joint display of quantitative and qualitative (new) results. This prevents the reader having to refer back.”

Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript.

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Please update your Data Availability statement in the submission form accordingly.

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7. We note that there is identifying data in the Supporting Information file <ECSERT Qual Supplementary Material_V1.docx>. Due to the inclusion of these potentially identifying data, we have removed this file from your file inventory. Prior to sharing human research participant data, authors should consult with an ethics committee to ensure data are shared in accordance with participant consent and all applicable local laws.

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-ID numbers that seem specific (long numbers, include initials, titled “Hospital ID”) rather than random (small numbers in numerical order)

Data that are not directly identifying may also be inappropriate to share, as in combination they can become identifying. For example, data collected from a small group of participants, vulnerable populations, or private groups should not be shared if they involve indirect identifiers (such as sex, ethnicity, location, etc.) that may risk the identification of study participants.

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Please remove or anonymize all personal information (<Age and Participant ID>), ensure that the data shared are in accordance with participant consent, and re-upload a fully anonymized data set. Please note that spreadsheet columns with personal information must be removed and not hidden as all hidden columns will appear in the published file.

8. We note that this data set consists of interview transcripts. Can you please confirm that all participants gave consent for interview transcript to be published?

If they DID provide consent for these transcripts to be published, please also confirm that the transcripts do not contain any potentially identifying information (or let us know if the participants consented to having their personal details published and made publicly available). We consider the following details to be identifying information:

- Names, nicknames, and initials

- Age more specific than round numbers

- GPS coordinates, physical addresses, IP addresses, email addresses

- Information in small sample sizes (e.g. 40 students from X class in X year at X university)

- Specific dates (e.g. visit dates, interview dates)

- ID numbers

Or, if the participants DID NOT provide consent for these transcripts to be published:

- Provide a de-identified version of the data or excerpts of interview responses

- Provide information regarding how these transcripts can be accessed by researchers who meet the criteria for access to confidential data, including:

a) the grounds for restriction

b) the name of the ethics committee, Institutional Review Board, or third-party organization that is imposing sharing restrictions on the data

c) a non-author, institutional point of contact that is able to field data access queries, in the interest of maintaining long-term data accessibility.

d) Any relevant data set names, URLs, DOIs, etc. that an independent researcher would need in order to request your minimal data set.

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2. The nature of the restrictions upon the data (ethical, legal, or owned by a third party) and the reasoning behind them

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4. If the data are owned by a third party, confirmation of whether the authors received any special privileges in accessing the data that other researchers would not have

5. Direct, non-author contact information (preferably email) for the body imposing the restrictions upon the data, to which data access requests can be sent

9. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 

10. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. 

11. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

**********

Reviewer #1: Clarity on clinical implications – Suggest, in the final discussion, how the findings can be translated into concrete recommendations for home-based rehabilitation programs in different healthcare systems.

Qualitative data – Although the justification for not making full transcripts available is valid, the authors could strengthen transparency by highlighting criteria for theoretical saturation and providing additional examples in the supplementary material.

Generalizability – More clearly acknowledge that the findings may reflect a group already motivated to exercise, and that applicability to less engaged recipients still needs to be tested.

Reviewer #2: Thanks for submitting your valuable manuscript, important topic very good and detailed methodology

Adding more objective measures is highly recommended please add this to your recommendations ,also longer follow up period .

**********

what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy

Reviewer #1: No

Reviewer #2: Yes:  Seham Elazab

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

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Understanding the feasibility of home-based rehabilitation in kidney transplant recipients: a mixed-methods interpretation

PONE-D-25-40533R1

Dear Dr. Billany,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager®  and clicking the ‘Update My Information' link at the top of the page. For questions related to billing, please contact billing support .

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Simone Borsci, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

**********

Reviewer #1: The revised version represents a clear improvement over the previous submission. The manuscript is now technically sound, logically structured, and written with clarity. The methodology is well detailed, and the discussion appropriately contextualizes the findings within current literature.

**********

what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy

Reviewer #1: No

**********