Following implementation of the kidney allocation system (KAS) in 2014, dialysis facilities referred more new dialysis patients and transplant centers evaluated more new patients even though fewer evaluated patients were placed onto the transplant waitlist, analysis of data from three southeastern states shows.
"Nationally, we have seen declines in waitlisting, which is an unintended consequence of this policy change. There is less urgency to waitlist patients earlier because they are not accruing time on the list based on the date they were placed on the list," Rachel Patzer, PhD, MPH, Emory University School of Medicine, Atlanta, Georgia, told Medscape Medical News in an email.
"And lower rates of active waitlisting could be a good — or a bad — thing," she added. As Patzer went on to explain, active listing usually means that the patient has gone through all their medical evaluation appointments and is ready to accept a kidney; if they are "inactive" on the waiting list, patients are not eligible to receive a transplant. "For the patient, being inactively waitlisted is not a good thing," she stressed.
Some patients are on the waiting list for many years, and because of this, transplant centers may be listing more patients as "inactive" to prevent the multiple evaluation visits that would be necessary if the patient made it again to the top of the waiting list.