*Purpose: This study examines the differential progress from beginning the transplant evaluation process to its completion and subsequent presentation to the Candidate Selection Committee (CSC) based on preemptive status, demographic, socioeconomic status, and clinical factors.

*Methods: We conducted retrospective analyses using electronic health record data for all patients referred to the transplant center from 6/1/2016 to 8/31/2021 for kidney evaluation, excluding patients referred after May 2021 and those with missing data from the multivariate models. Logistic regression was used to evaluate progress from evaluation to CSC presentation, adjusting for demographic, socioeconomic, and clinical factors. Two models were used to compare preemptive status, a binary based on self-reported data from the initial referral telephone encounter. The Area Deprivation Index (ADI) is a proxy measure for socioeconomic status (SES) that uses address to identify census cell block to quantify a score for intra- and interstate comparison of disadvantage, which is ranked between 1-100 with one equating to the lowest level of disadvantage. Other variables included distance to center, payor at referral (primary and secondary), Estimated Post Transplant Survival (EPTS) score, referral reason (CMS classification), BMI, and smoking status. *Selected results are included in the table.

*Results: Glomerulonephritis and Cystic/Hereditary/ Congenital/Other Diseases, Medicaid as a secondary payer, and smoking status were statistically significant predictors of reaching CSC for the preemptive population. Importantly, race and ethnicity were not predictive in this group. Black race, EPTS, Body Mass Index (BMI), Cystic/Hereditary/ Congenital/Other Diseases, and smoking status were statistically significant predictors for the non-preemptive population.

*Conclusions: Preemptive patients seem to be fundamentally different than non-preemptive patients, which encourages patient engagement activities and intervention earlier in the disease progression. The lack of racial and ethnic disparities in the preemptive patient population could support a shift from focusing on racial and ethnic disparities to a focus on social determinants of health and identifying resource and support needs. Gi that the ADI loses statistical significance in our examination of progression to CSC, it may be appropriate to focus interventions in prior to or in the beginning of the pre-transplant phrase.

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