Absent mitigation strategies, a mere 7% increase in U.S. kidney transplant candidates could prolong the wait list by nearly two years, according to a Stanford University-led study published March 24 in JAMA Network Open.
Current wait times are difficult to estimate due to wait list removals, such as deteriorating health status and candidate deaths. Additionally, fewer than 50% of patients waitlisted 10 years ago have received a kidney transplant, rendering the median time incalculable, according to researchers.
Still, fewer than 50,000 kidney transplants occurred in 2024 while more than 103,000 patients are on the current national wait list, according to HHS.
Only 12% to 18% of patients receiving dialysis are on the kidney transplant wait list, the researchers said. A recent study of dialysis units in the southeast U.S. estimated that between 21% and 25% of those patients could benefit from a transplant.
Expanding the wait list is “often proposed as a method to alleviate racial, ethnic and socioeconomic disparities in access to transplantation,” but without efforts to increase organ supply, healthcare access will falter, the study found.
If the wait list grew by 10% annually, the median wait time would be about three years — two months longer than the status quo. A 50% increase each year would result in wait times close to 4.4 years, according to the researchers’ modeling.
To maintain or reduce wait times, the 10% increase in candidates would require 2,850 additional kidneys, while 50% growth would require at least 11,000.
“The upper limit of patients who might benefit from transplantation is unknown, but estimates from other countries suggest that at least 50% of patients with [end-stage kidney disease] may be eligible for transplantation,” the study authors wrote.