Analysis of the wait list and deaths among candidates waiting for a kidney transplant.
BACKGROUND
The status (active vs. inactive) and the characteristics of patients waiting for a kidney transplant and those dying on the kidney waiting list were analyzed to make a current assessment of the kidney waitlist. Candidates designated as inactive on the kidney waiting list were examined to determine total length of time with inactive status and total time on the list.


METHODS
The number and proportion of kidney waitlist candidates with inactive status at any point in time on the waiting list has increased substantially over the last several years. At the end of 2007, 24,624 candidates on the kidney waiting list (32.8%) were categorized as inactive compared with 9186 (16.1%) at the end of 2003.


RESULTS
The percentage of patients who died categorized as inactive on the kidney waiting list has also increased markedly from 31% (n=1197) in 2003 to 52% (2431) in 2007. Among the 2431 candidates, who died with inactive status while waiting for a kidney during 2007, 1281 (53%) were inactive for longer than 1 year over the entire course of their time on the waiting list, and 1132 (47%) were not listed as active status consecutively for more than 1 year before their death.


CONCLUSIONS
"Inactive" patients are not eligible to receive an offer for a deceased donor kidney, even though they are on the list. Patients who died inactive and never received an offer for a kidney during the period of listing are not served well by extended periods of inactivity.
Delmonico
Francis L
FL
Department of Surgery, Transplantation Center, Massachusetts General Hospital, Boston, MA 02114-2696, USA. francis_delmonico@neob.org
McBride
Maureen A
MA
D006291:Health Policy; D006801:Humans; D007674:Kidney Diseases / Q000401:mortality* / Q000601:surgery*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D016019:Survival Analysis; D006113:United Kingdom; D014850:Waiting Lists