A kidney transplant is often the best treatment for end-stage kidney disease (ESKD). It can help patients live longer, and with a better quality of life than long-term dialysis can provide. Unfortunately, the process of getting a kidney transplant can be complicated and confusing. The National Kidney Foundation (NKF) answers some common questions about the transplant waitlist.* 

What is the transplant waitlist?

The United States kidney transplant list is managed by the United Network for Organ Sharing (UNOS). UNOS tries to ensure that deceased donor kidneys are distributed fairly. Matches are made based on multiple factors including:

• Blood-type and antibody matching
• Time with kidney failure
• Age (child v. adult)
• Being a past live kidney donor
• Medical urgency (how sick you are)
• Where you live 
• Weight and size compared to that of the donor, ideally more similar
• Age compared to the donor, ideally in the same age range

When should I start thinking about a kidney transplant?

Ideally, you should discuss the option of a transplant with your doctor before you start dialysis. Once you have an estimated glomerular filtration rate (eGFR), or kidney function, of 20 or less, you are eligible for evaluation by a transplant center. 

How do I get on the transplant waitlist?

There are many transplant centers spread throughout the U.S. Ask your doctor or healthcare team for a referral to a local transplant center. You can also contact a transplant center, or multiple centers, yourself without a referral. Each transplant center will explain its specific process and criteria, which will allow you to pick one that best fits your needs. 

Things you may want to consider when choosing a transplant center are:

• Insurance cost and coverage
• Location
• Whether or not they perform living donations (if you have a living donor)
• Whether or not the center offers a support group

Some transplant centers have restrictions that may disqualify candidates with certain health conditions, advanced age, obesity, current smoking status, and/or active substance abuse. The transplant team will complete an evaluation and decide if you are eligible to be a candidate at their center. Once a candidate, you will be added to the national waiting list. 

What is the average wait time for a kidney transplant?

At most centers, the average time frame for waiting is 3-5 years, however, it can be longer in certain parts of the country. Some other factors that affect wait time are blood type, prior pregnancies, blood transfusions, or past transplants. Ask your transplant center to get a better understanding of what your wait time may be. 

Can I be listed at multiple transplant centers? 

Yes, you can be a candidate at multiple transplant centers. Generally, people will choose the center closest to their home, but it is possible to join the list at multiple centers. This can sometimes make your wait time shorter. 

While a transplant is the best treatment for many people with ESKD, it is not for everyone. Speak directly with your healthcare team to determine how a transplant would affect your overall health and quality of life. 

*The Kidney Transplant Waitlist – What You Need to Know. (2022, September 16). National Kidney Foundation. Retrieved October 20, 2022, from https://www.kidney.org/atoz/content/transplant-waitlist