What You Should Know About the National Kidney Transplant Waiting List

For many of the millions of people living with kidney failure, a kidney transplant is considered the most ideal and desirable treatment option. However, transplantation is a process that can take months or even years due to the number of people in need of a new kidney.

If you don’t have a living kidney donor or if your donor arrangements aren’t finalized, registering on the national kidney transplant waiting list for a donor kidney is an important step. Once you’ve registered–with help from your social worker and a referral–you’ll be on the list to receive a kidney from a donor when a match becomes available.

Below, we’ve provided a list of questions to help you understand how the kidney transplant waitlist works and how to get on the list.

You are eligible to be evaluated for placement on the kidney transplant waitlist when your (glomerular filtration rate) GFR is 20 or below. A GFR of 20 falls under stage four of chronic kidney disease, meaning there is severe loss of kidney function but the kidneys have not yet failed.

After determining with your doctor that a transplant is a treatment option for you, you’ll need a referral. You can get a referral from your physician or self-refer.

The next step is to find an area transplant hospital. The Organ Procurement and Transplantation Network (OPTN) has a list of 200+ such hospitals in the United States. You should look for a facility that will work with/for your insurance, travel, financial, and support needs.

The final step is an evaluation by the hospital's transplant team. This typically starts with a phone conversation, during which you’ll set up an in-person appointment with members of the transplant care team. You will also undergo a full health exam. If your exam shows you’re a transplant candidate—meaning you are physically and mentally prepared for the transplant process—you’ll be added to the national waitlist. The sooner you can get on the list, the sooner you may find a matching donor.

Once you register to be on the kidney transplant waitlist, there may be a fairly long wait. There are approximately 100,000 people on the waitlist¹ and the average wait time for a kidney from a deceased donor is three to five years.²

The United Network for Organ Sharing (UNOS) manages the national list of people waiting for an organ transplant. Because transplants are generally more successful when the transport time for an available kidney to the transplant facility is minimized, the UNOS matching system factors in the distance between a donor and the transplant center when selecting a match. It should be noted that requirements for accepting transplant patients differ from one transplant center to another.

Your transplant coordinator will send you a formal letter to inform you of your official placement on the waitlist and confirm your active status. If a matching kidney becomes available, your coordinator will notify you immediately.

Staying healthy means you’ll be more physically, medically, and mentally prepared when a kidney becomes available. Tips for staying your healthiest include:

• Attend medical appointments and evaluations.
• Keep up with dialysis therapy, medications, and vaccinations.
• Eat healthy, exercise, and cut out bad habits like smoking.
• Seek out the emotional and mental support you need.

Receiving a transplant can be a life-changing experience for a person with kidney disease¬—a means of restoring one of the body’s most important natural processes and getting part of your life back. If you or a loved one is considering transplantation to treat kidney failure, getting on the waitlist as soon as possible is a critical first step.