A recent study led by Stanford University, published on March 24 in JAMA Network Open, has highlighted an alarming statistic: Without necessary mitigation strategies in place, a seemingly insignificant rise of 7% in kidney transplant candidates in the U.S. could potentially extend the waiting list by a staggering two years. Estimating current wait times is a complex task, mired in complications due to wait list attritions — for instance, the decline in the health status of candidates and, regrettably, deaths while waiting for transplants. Disturbingly, less than half of those who joined the waiting list a decade ago have managed to receive a kidney transplant. This unexpected scenario has rendered the calculation of median wait time impossible, the researchers acknowledged.
Presently, despite over 103,000 patients on the national waiting list as per the records of the Health and Human Services (HHS), fewer than 50,000 kidney transplants took place in 2024. The study further reveals that a mere 12% to 18% of patients undergoing dialysis are on the waiting list for kidney transplant. However, based on an analysis of dialysis units in southeastern U.S., it is estimated that between 21% and 25% of dialysis patients could potentially stand to benefit from a transplant.
Frequently, expanding the waiting list is portrayed as a viable approach to mitigate racial, ethnic, and socioeconomic disparities in transplantation access. Yet the study argues that such an attempt, unaccompanied by plans to increase organ supply, could lead to a collapse of healthcare access as the organ supply-demand equilibrium falters. A hypothetical 10% annual expansion of the wait list could prolong the median wait time to around three years, marking an increment of two months compared to the current wait time. A drastic 50% annual increase, however, could extend wait times close to 4.4 years as per the researchers’ predictive modeling.
The study confirms that a 10% increase in candidates will necessitate an additional 2,850 kidneys, and a 50% growth will require no fewer than 11,000 kidneys, to maintain existing wait times. Furthermore, the data reveals an uncertain upper limit of patients who might benefit from transplantation, with evidence from other countries hinting that at least 50% of end-stage kidney disease patients might be transplantation-eligible.
Source: https://www.beckershospitalreview.com/quality/the-growing-needs-in-kidney-transplantation/