*Purpose: Barriers to deceased donor kidney transplantation (DDKT) exist, including referral for transplant and waitlist addition, which may vary regionally. The objective of this study was to assess the state-level period prevalence of end-stage renal disease (ESRD) patients eligible for DDKT and to measure access to the waitlist among this population.

*Methods: Methods: The 2016 United States Renal Data System database was used to estimate the 2014 period prevalence of adult (18-74 years) ESRD patients eligible for DDKT in 2014, per our transplant center’s standardized criteria (1/1/2014-12/31/2014). Based on UNOS data, the proportion of waitlisted candidates per eligible ESRD patients was calculated. Spearman’s correlation was used to evaluate the association between ESRD burden and proportion of transplant-eligible patients who were waitlisted, by state.

*Results: Among 450,828 ESRD patients identified, 364,358 were eligible for transplant per criteria. ESRD eligible patients varied geographically, and there was significant variation in the proportion of transplant-eligible ESRD patients who were waitlisted, with a mean of 24.84 per 100 eligible patients (Figure 1). A negative correlation existed between state-level ESRD burden and proportion of eligible patients who were waitlisted (r =-0.39, p=0.01).

*Conclusions: Geographic variation existed for waitlisting practices among transplant-eligible ESRD patients, and higher burden of ESRD was not associated with higher proportion of waitlisted transplant-eligible patients. Therefore, waitlist size may be more of a reflection of center/state-level practices than true disease burden. Moreover, on a national and state level, opportunity exists to provide greater access to the waitlist among patients with ESRD.

« Back to 2020 American Transplant Congress