Managing the kidney waiting list.

Candidates on the kidney transplant list wait for longer periods and have increasing numbers of comorbid conditions. To ensure that these candidates are acceptable for transplantation when an organ becomes available, physical, psychosocial, and financial strategies are essential. The authors surveyed 68 transplant centers to determine current practices. Eighteen percent of centers did not reevaluate candidates. Other programs used time on the list, disease, age, or a combination of these factors as evaluation criteria. Initial cardiac evaluation was relied upon by 51.4% of centers, with varying criteria used to determine status. Social work evaluation was done by 42.6% of centers, usually annually. Annual financial reevaluation was performed in 57.4%. Data support reviewing candidates, especially those with diabetes, those who have been receiving dialysis for a long time, and those older than 60 years. The dedication of one coordinator to manage waitlisted candidates using age, diagnosis, and time receiving dialysis was effective in this study.