*Purpose: In 2018, there were more than 100,000 patients wait-listed for kidney transplant whereas only around 21,000 patients received a kidney transplant. Increasing access to transplantation and reducing the burden of dialysis saves lives, costs less, and is the key corner-stone of the American Kidney Health executive order.

*Methods: We report the experience of kidney transplants from a tertiary care academic transplant center (2016-2018) to utilize outreach clinics in improving access to transplantation, particularly in suburban and rural geographic areas. Basic demographic information was collected in a de-identified cohort. Outreach area was defined as patients/referrals originating from those zip-codes outside of the metropolitan and adjacent counties.

*Results: The process of establishing outreach clinic sites included stakeholders from the health system (transplant administration, nursing, social work, legal, and providers) and partnering with community practices to plan evaluations, education and wait-list management for these patients. During the study period we established 7 clinic locations in these areas, which provided a referral resource to 15 different community nephrology practices. Outreach clinics locations spanned over a 125-mile radius from the transplant center, and each clinic location further provided a referral catchment area of an additional 100 mile radius, thus signifying a large geographic impact. Between 2016-2018 there were a total of 2,320 referrals to our transplant center of which 1,728 patients (75%) originated from outreach areas. Eligible candidates underwent evaluations, including work-up at community sites, with an approach to limit travel to the transplant center. Outreach activity also included interacting with patients, families and local providers to increase awareness for transplant including living kidney donation. Listing process mirrored the current standards of care. These 2,320 referrals resulted in 314 kidney transplants to date, of which 226 (72%) originated from outreach areas. Overall, living donor transplant rate was 42% (131/314) and it was 43% (97/226) for outreach patients. Of note, the overall impact of live donation was significant from outreach areas constituting 74% (97/131) of all living donor transplants. The post-transplant care in all patients followed our standard institutional protocols independent of source of transplants.

*Conclusions: We successfully demonstrate the development of an outreach program to seamlessly improve access to kidney transplants in suburban and rural areas. The program has not only contributed to significant growth in the total number of transplants but also increased awareness as demonstrated by a high proportion of living donor transplants. In the upcoming era of changes to kidney disease management, such models set an example to improve survival and reduce the overall costs of care.

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