The kidney transplant waiting list in the United States
- Edmund Huang, MD
Edmund Huang, MD
- Associate Professor of Medicine
- University of California, Los Angeles School of Medicine
- Cedars-Sinai Medical Center
- Gabriel Danovitch, MD
Gabriel Danovitch, MD
- Distinguished Professor of Medicine
- University of California, Los Angeles
- Section Editor
- Daniel C Brennan, MD, FACP
Daniel C Brennan, MD, FACP
- Editor-in-Chief — Nephrology
- Section Editor — Renal Transplantation
- Professor of Medicine
- Medical Director and Co-Director of the Comprehensive Transplant Center, Department of Internal Medicine, Division of Nephrology
- Johns Hopkins Medical School
As of January 2015, there were approximately 110,000 patients registered on the United Network for Organ Sharing (UNOS) kidney transplant waiting list in the United States; of these, 60 percent were designated as active status on the waitlist, or eligible for a transplant if a kidney is offered . Registration on this list by individual transplant programs is required before a patient can be allocated a deceased-donor organ.
This topic reviews the composition of and access to the kidney transplant waitlist in the United States, as well as the management of patients while they await kidney transplantation.
The details of the allocation algorithm for deceased-donor kidneys and issues related to the evaluation of the kidney transplant candidate are discussed separately. (See "Organ sharing in kidney transplantation" and "Evaluation of the potential renal transplant recipient".)
THE ACTIVE AND INACTIVE WAITING LIST
Candidates may be registered on the waiting list and accrue time towards deceased-donor kidney transplantation at any time after a diagnosis of irreversible kidney disease is made and the glomerular filtration rate (GFR) decreases to ≤20 mL/min. The GFR can be determined by any modality, including direct measurement or any of the available estimating equations. (See "Assessment of kidney function", section on 'Assessment of GFR'.)
For candidates ≥18 years old, the calculation of waiting time (which is used to prioritize candidates for kidney allocation) is based upon the earliest of the following:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- THE ACTIVE AND INACTIVE WAITING LIST
- DEMOGRAPHICS OF THE WAITING LIST
- WAITING TIME
- DEATH ON THE WAITING LIST
- ACCESS TO THE WAITING LIST
- HEALTH CARE OF TRANSPLANT CANDIDATES
- Routine health maintenance
- Cardiovascular testing
- Physical activity
- Obesity and weight loss
- INFORMATION FOR PATIENTS