Many patients with top 20% Estimated Post- Transplant Survival (EPTS) are not waitlisted for kidney transplant, according to a study published in the Journal of the American Society of Nephrology. Noting that the national Kidney Allocation System prioritizes patients with top 20% EPTS, researchers examined the incidence of waitlist placement among qualifying pa- tients. A total of 42,445 patients with top 20% EPTS were included; 7,922 were preemptively waitlisted. The researchers found that 3-year waitlisting incidence was 37% among the 34,523 patients initiating dialysis. A reduced hazard of being waitlisted was seen for African- American versus Caucasian individuals and for residents in the lowest- versus the highest-in- come neighborhoods (0.76 and 0.52, respective- ly). Sixty-one percent of those initiating dialysis and 18% of preemptively listed patients lost top 20% EPTS within 30 months. For dialysis- initiated patients, the 3-year incidence rates of deceased and living donor transplantation were 5% and 6%, respectively, compared with 26% and 44%, respectively, among preemptively listed patients.
