Nearly Half of Kidney Transplant Patients Never Start Evaluation Process, Study Finds
A new study reveals that 48% of kidney failure patients referred for transplantation never begin the evaluation, and only 19% make it to the waitlist. Barriers include social, geographic, and demographic factors.
Gaps in the Kidney Transplant Pathway
According to a large US study, nearly half of patients with kidney failure who are referred for a kidney transplant never begin the evaluation required to be considered for a donor organ. The research, led by NYU Langone Health, analyzed data from 720,348 patients referred for kidney transplantation between 2014 and 2025.
Findings show that only 19% of referred patients completed the evaluation and were placed on the transplant waitlist, while 48% never started it at all. Researchers note that much attention has been given to patients after they reach the waitlist, but far less is known about the barriers before that point.
Key Barriers
The study identified several factors that reduce the likelihood of advancing through the process. Patients who were unmarried, had severe obesity, or lived in rural communities were less likely to start or complete the evaluation. Older adults, Spanish speakers, and those with lower incomes faced greater challenges. Patients treated at smaller transplant centers or programs in the Southern US also had lower chances of waitlisting.
The evaluation process is complex, involving multiple appointments for blood tests, imaging, and cancer screenings over several months while patients continue dialysis. Smaller centers may have fewer resources, and patients with limited social support may struggle with transportation and scheduling.
The findings were published June 20 in the Journal of the American Society of Nephrology and presented at the American Transplant Congress.
