MONDAY, June 22, 2026 (HealthDay News) — Less than a fifth of Americans referred for kidney transplants complete the steps necessary to get their name on the waitlist.
"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," said lead author Dr. Conor Donnelly, a surgical resident at NYU Grossman School of Medicine in New York City.
Nearly half never even start the process to be considered for a new organ, according to a study of more than 720,000 patients published online June 20 in the journal Clinical Research.
"Which transplant center you go to, where you live and even whether you are married all appear to influence your chances of moving forward to the waitlist for a new kidney," Donnelly said in a news release.
Patients who were older, poor, unmarried, living in rural areas and Spanish-speakers were most unlikely to start or complete an evaluation and make the waitlist. Those living in the South or being cared for at smaller treatment centers were also unlikely to move ahead.
In all, a scant 19% of referred patients completed the evaluation, and 48% never got started, the study found.
The requirements aren’t always easy to navigate, researchers said.
Once a transplant referral is made, patients undergo an extensive battery of tests — from blood work and chest imaging and even cancer sceenings — all while attending dialysis sessions several times a week.
Patients are added to the waitlist only after completing this process.
Those in urban areas where transplant centers are often closer to home are more likely to move forward in the process, the study found.
Candidates who are unmarried or lack strong social support may find it difficult to make repeated trips for evaluations and follow-ups.
For the study, researchers drew on more than 300 million electronic health records from more than 1,850 hospitals, including more than a third of U.S. transplant centers.
They focused on referrals from 2014 to 2025, examining how a variety of factors, from sex and age to geographic location and medical history affected a patients’ chances of moving from referral to evaluation and then to the waitlist and transplant.
The study also showed that smaller centers with fewer transplant slots may be more choosy about which patients they accept.
Nationwide, 90,000 people are waiting for a kidney, according to UNOS, which manages parts of the U.S. organ donation and transplant system. Every day, 11 of those folks die, waiting for an organ.
"Finding ways to reduce barriers to both evaluation and waitlisting could help expand much-needed access to kidney transplantation," said study co-author Allan Massie, an associate professor of surgery and population health at NYU Grossman School of Medicine.
One way to start, he said, would be to better educate patients, while providing support as they navigate the complex and "sometimes grueling" process.
The findings are also being presented in Boston at the American Transplant Congress, a joint meeting of the American Society of Transplantation and the American Society of Transplant Surgeons that began Saturday.
More information
Learn more about organ transplantation and enroll as a donor at UNOS.
SOURCES: NYU Langone Health, news release, June 20, 2025; Clinical Research, online, June 20, 2026
Copyright © 2026 HealthDay. All rights reserved.
