Even past the known barrier of referral for transplant, a significant percentage of patients do not complete the required medical evaluation. We therefore determined if particular demographic, socioeconomic or medical characteristics were associated with non-completion of the medical evaluation in a renal transplant population. This study involved a retrospective chart review of a cohort of eligible patients seen for an initial evaluation at a renal transplant clinic between October 1, 2009 and September 30, 2010 (n=203). The primary end point was non-completion of the medical evaluation 12 months from initial visit. Independent variables included socioeconomic, demographic, and medical factors analyzed using multivariable logistic and linear regression. Mean age was 48.5 years; 54.2 % were male; 51.2% were black, 26.1% Hispanic, and 22.7% white/other. Approximately one fourth (26.3%) did not yet require dialysis. During follow-up, 54 patients (26.7%) did not complete the medical evaluation. Multivariable analysis indicated black race (odds ratio (OR) 2.0, overall race effect p=0.003), being on dialysis (OR 2.7, p=0.04) and a prior incomplete pre-transplant evaluation (OR 3.9, p=0.01) were significantly associated with non-completion. Hispanic ethnicity was associated with a lower likelihood of non-completion (OR 0.3, overall race effect p=0.003). Race was not confounded by socioeconomic variables or by social support. In the subgroups of patients with complete data on the respective test, needing a stress test (OR 3.6, p=0.02) or a carotid duplex (OR 2.8, p=0.047) was also significantly associated with non-completion. In the 149 patients who completed the evaluation, requiring cardiac catheterization, pulmonary function tests or a carotid duplex increased time to completion 50-60 days in men and women, while a stress test increased the time 70 days in women only. There was significant racial disparity in completion of the pre-transplant evaluation, not accounted for by socioeconomic or medical factors. Requiring dialysis, having a prior incomplete evaluation, and specific tests were associated with non-completion. Requiring certain tests was also associated with a longer time to completion. These factors might identify patients who may benefit from more assistance with the transplant evaluation.

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