Use of transplant status codes to monitor access to kidney transplantation

The kidney transplantation process involves a series of steps related to interest in transplantation, medical suitability, pretransplant workup, and eventual transplantation. We developed transplant status codes to monitor the progress of dialysis patients in Ohio, Kentucky, Indiana, and Illinois as they move through these steps. Of the first 2,137 dialysis patients monitored with these new codes, 29% were interested in receiving a transplant, 31% were medically suitable to receive a kidney transplant, 15% had completed a pretransplant workup, 13% were on a cadaveric transplant waiting list, and 2% were awaiting a living-related transplant. Examination of these steps by gender showed differences in interest (men 32% v women 26%, P =.01) and medical suitability (men 33% v women 28%, P =.01). The proportion of patients successfully completing each step differed across facilities. In conclusion, transplant status codes are a useful method to monitor access to transplantation. As part of a facility-specific quality improvement program, such codes may be used to develop targeted interventions to help patients move through the transplant process as expeditiously as possible.