Characteristics of Patients on the Transplant Waitlist

Austin, Texas—The optimal treatment for patients with end-stage renal disease (ESRD) is renal transplantation. The qualification process for transplantation is complex and difficult to navigate for some patients. Deborah Evans, MA, LCSW, and colleagues conducted a data analysis to characterize patients listed as active on the transplant waiting list to improve understanding of the challenges involved in qualifying for a transplant. Results of the analysis were reported during a poster session at the NKF 2018 Spring Clinical Meetings in a poster titled Characterization of End-Stage Renal Disease (ESRD) Patients on the Transplant Waitlist.

Data from the electronic health records of a large dialysis organization were utilized in the analysis. Transplant waitlist status as of November 2017 was examined. The analysis compared patients listed as active with the overall patient population within categories of age, sex, race/ethnicity, dialysis vintage, modality, and geographic region.

The proportion of male patients listed as active was higher than that of female patients (10.6% vs 8.1%). There was variation in status listed as active by race/ethnicity: Hispanic, 11.9%; black, 9.9%, and white, 7.6%. Patients <40 years of age had the highest proportion of patients listed as active (18.5%) and those >80 years of age had the lowest proportion (0.2%); the proportion with status listed as active increased with dialysis vintage (1.7% for patients on dialysis <3 months vs 13.5% for those on dialysis 24-48 months).

When measured by dialysis modality, 8.1% of patients on in-center hemodialysis were listed as active, compared with 20.3% of those receiving home dialysis, and 20.1% of patients receiving peritoneal dialysis. When considered by state, the proportion of patients listed as active varied from 3.4% to 17.1%.

“Our analysis revealed considerable variation in the proportion of patients listed as active on the transplant waitlist based on a number of demographic and dialysis treatment criteria. It is likely that some of these differences reflect patient health status and engagement as well as factors specific to individual transplant programs. However, these findings may inform the design and targeting of education to ensure that all patients are able to make informed decisions about transplant as an alternative to their current modality,” the researchers said.

Source: Evans D, Dunn D, Robinson K, Sossamon S, Benner D. Characterization of end-stage renal disease (ESRD) patients on the transplant waitlist. Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.

This study was funded by DaVita, Inc.