Waiting time modifications for candidates affected by race-inclusive eGFR calculations

On this page:

• Background
• Policy
• FAQs & education
• Post-implementation monitoring

The Organ Procurement and Transplantation Network (OPTN) Board of Directors unanimously approved a policy action in December 2022, that requires hospitals to assess their waiting lists and backdate the waiting times of Black kidney transplant candidates who were disadvantaged by previous use of a race-inclusive calculation. This policy took effect January 5, 2023.

• If you are a Black patient and you need a kidney transplant, this page has information to help you understand what you can expect.
• If you are a transplant professional, this page has information about what is required of your hospital.

Some Black kidney candidates will be eligible to receive waiting time modifications that increase their waiting times. Waiting time is one of the most important factors in getting a kidney.

As part of the updating waiting times process, transplant hospitals will notify candidates about the policy change. Transplant hospitals will also locate documentation related to each candidate’s medical history and provide it to the OPTN. In some cases, patients may be able to provide this information to the transplant hospital.

Jump to FAQs about waiting time modifications

Professional education

• Review policy change impacts and understand policy process needs in an educational offering in the OPTN Learning Management System, known as UNOS Connect
  • KID118: Waiting Time Modifications for Kidney Candidates Affected by Race-Inclusive eGFR Calculations
• Access a custom reporting tool in the OPTN Computer System (known as UNet℠) Data Services Portal
  • The OPTN Data File “Current Waitlisted African American Candidates” provides a list of current kidney candidates reported with African American/Black as a Race category with wait time qualifying information

During the March 15 webinar, OPTN Kidney Transplantation Committee chair Martha Pavlakis, M.D., walked kidney transplant professionals through the notification and modification process and answered questions from the community.

eGFR webinar Q&A themes (PDF - 195 KB)

eGFR webinar effective practices (PDF - 102 KB)

During the July 12 webinar, panelists from several kidney programs shared effective practices regarding the OPTN eGFR waiting time policy action requiring programs to modify waiting time for candidates affected by race-inclusive eGFR calculations.

More about race-inclusive eGFR calculations

For patients

• Understanding race & eGFR
• FAQs about the 2022 requirement for race-neutral eGFR calculations (PDF - 750 KB)

For professionals at kidney programs

• FAQs about the 2022 requirement for race-neutral eGFR calculations (PDF - 723 KB)

Post-implementation monitoring

Improving equity in access to transplant opportunities for patients is an OPTN strategic goal. OPTN members are expected to comply with requirements in the policy language.

In addition to the compliance monitoring outlined in the policy language, all elements required by policy may be subject to OPTN review, and members are required to provide documentation as requested.

The proposed language will not change the current routine monitoring of OPTN members. The OPTN will review the submission of all required documentation and will refer any transplant programs found not in compliance with the policy requirements at the end of the implementation period to the Membership and Professional Standards Committee (MPSC). The MPSC will review all relevant information to determine if a policy violation has occurred and what type of action is warranted.