E-Kidney | August 2012

From Evaluation to Transplant List, 180 Days Faster

Top 5 Rome may not have been built in a day, but a new study found that a one-day, centralized work-up coordinating all of the tests and assessments needed for transplant evaluation significantly cut the length of time it took to get on the transplant list. This research was published in the August issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

Patients who underwent this one-day workup were added to the list in an average of 46 days while those who went through standard, piecemeal evaluations had to wait, on average, 226 days. On average, patients were listed in approximately six months less time if they received the one-day evaluation. The one-day workup also had slashed at waiting list disparities, which tend to disfavor minority groups and the economically disadvantaged.

"Studies have shown that the longer a kidney patient waits to be placed on the list, the higher the risk of death following a successful transplant," said Sanjay Kulkarni, MD, the lead author on the study and the Director of Kidney & Pancreas Transplantation at Yale University School of Medicine. "By markedly reducing the listing time, we hope to improve patient survival following transplant, increase access to a kidney transplant faster, and decrease dialysis exposure."

Typically, kidney transplant evaluations are coordinated between patients and their doctors. The comprehensive evaluation involves numerous tests for potential medical problems, as well as surveys and questions regarding issues such as a patient's financial status and family support network. Kulkarni's team instead used a one-day procedure that was handled in the transplant centers.

"A transplant center's willingness to adopt the responsibility translates into better access to kidney transplant and potentially could improve patient outcomes," he noted.

"More than 90,000 Americans are on the waiting list for kidney transplants and we certainly need more donors. But so many who suffer from kidney failure never even have a chance to get on the waiting list.," said Dr. Kerry Willis, National Kidney Foundation Senior Vice President for Scientific and Medical Activities. "Getting patients on the waiting list quickly should save lives, reduce disparities and improve transplant outcomes."