Kidney transplantation saves lives. For many people with kidney failure, transplant offers longer survival, greater quality of life, and lower associated costs compared to dialysis. But the waitlist is long -- approaching 100,000 people in the United States -- and the waiting time is usually measured in years and varies across the country. (1)
Many nephrologists have expressed frustration over a lack of transparency in thenational kidney transplant waitlist that makes it difficult for the nephrology care team to actively monitor a patient's status -- active or inactive.
The process itself reflects major inequities. Black Americans are less likely than white Americans to:
be identified as transplant candidates;
referred for evaluation;
put on the kidney transplant waitlist;
receive a kidney transplant; or
receive a higher-quality kidney from a living donor.
Black Americans are more likely to receive lower quality kidneys and experience poorer transplant graft survival.
ASN and other members of the kidney community met with Health Resources & Services Administration (HRSA) officials this week to discuss waitlist challenges and the need to increase access to transplant waitlist data for nephrologists and other healthcare professionals.
ASN is pushing for greater access to, and transparency of, active and inactive status for patients referred for kidney transplantation. This is part of a broader ASN initiative to improve kidney transplantation through a variety of efforts including advocating for the Biden Administration to finalize the Organ Procurement Organization metrics final rule, increase transparency and streamlining of the transplant approval process, and, ultimately, an increase rates of kidney transplantation in the US.
Recently published research in JASNdemonstrated that waitlist practices have not improved waitlist times over the last two decades. "Our study highlights the failure to improve waitlisting for ESRD patients, particularly our most vulnerable patients over the past two decades. Improving this will require several changes, including in the policy arena," said Sumit Mohan, MD, MPH, FASN, and one of the study's authors.