Lower likelihood of initiating evaluation for patients who were never married, had severe obesity, were from rural areas
THURSDAY, July 2, 2026 (HealthDay News) — A considerable proportion of patients referred for kidney transplantation do not even initiate evaluation, according to a study published online June 20 in the Journal of the American Society of Nephrology to coincide with the annual American Transplant Congress, held from June 20 to 24 in Boston.
Conor B. Donnelly, M.D., from NYU Grossman School of Medicine in New York City, and colleagues assessed stage-specific progression and attrition in the process of evaluation, waitlisting, and kidney transplantation using electronic health record data on all patients referred for kidney transplantation from 2014 to 2025. Data were included for 720,348 referred candidates.
The researchers found that of the referred candidates, 48, 19, and 10 percent initiated evaluation, were waitlisted, and ultimately underwent transplantation, respectively. The median time to evaluation initiation was two months after referral among those who initiated evaluation, while the median time to waitlisting was four months after initiation of evaluation. The likelihood of initiating evaluation was lower for patients who were never married, had severe obesity, or were from rural ZIP codes (relative risks, 0.94, 0.70, and 0.98, respectively). Lower relative rates of transplantation were seen at low-volume centers (relative risk, 0.92). Not meeting criteria/not a candidate, patient decision, unable to contact, death, and financial/insurance complications were reasons for removal in centers with documentation for nonprogression to evaluation (18, 13, 12, 4, and 7 percent, respectively).
“Our findings suggest that a substantial proportion of people who need a new kidney fall out of the process long before they reach the waitlist, let alone make it to the operating room,” Donnelly said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
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