Regulatory Policy

Removing Barriers to Treatment

We recognize that transplant is the best treatment option for individuals whose kidneys have failed, but there are many inequities inherent in the system that these individuals experience, creating barriers for the vast majority of people with kidney failure. It is important that the barriers in the transplant setting are addressed to facilitate referrals from nephrologists and facilities.

The primary reason transplant is so inaccessible for so many individuals living with kidney failure is that tens of thousands of individuals are on kidney transplant waitlists, yet there are only a few thousand organs available. And, even if there were enough organs available, the current inefficient processes lead to only a fraction of patients being listed, with only 19.5 percent of patients receiving a transplant after one year between 2009 and 2013. Disparities are also prevalent in transplant, as Black individuals are less likely to be placed on a waitlist than white individuals, and also experience median wait times that are twice as long.

KCP recommends that HHS work across the agencies responsible for transplant and consider improving communication and transparency among patients, transplant centers, organ procurement organizations, dialysis facilities, and nephrologists; expand educational opportunities for individuals with kidney disease and potential donors; address barriers to accessing transplant, especially those related to social determinants of health; improve transplant quality performance; and reform reimbursement.

Comment Letters & Resources: