Many older adults living with advanced kidney disease face challenges during the transplant evaluation process. A recent study highlighted five key barriers that can make it harder to get listed for a kidney transplant, including complex testing requirements and limited communication from transplant teams.

A successful kidney transplant can greatly improve quality of life and help people live longer. But getting approved for a transplant involves a lengthy evaluation process, including multiple tests, screenings, and visits with specialists to assess overall health.

This process can be especially difficult for older adults, who often manage other chronic health conditions alongside kidney disease. For some, the burden of navigating appointments and criteria can feel overwhelming.

Researchers interviewed 26 adults aged 65 and older with advanced kidney disease, along with seven of their family members. Participants said the evaluation process was long, unclear, and emotionally draining. Many felt unsure whether they were making progress and worried that missing a step could affect their eligibility.

Researchers identified five common obstacles among those they interviewed.

• Lengthy and complex evaluation — The evaluation often takes months or even years, with many tests, screenings, and specialist visits. Some participants called it a “never-ending” cycle.
• Unclear criteria and lack of transparency — People said it was hard to get clear answers about transplant eligibility or where they stood in the process.
• High personal burden — Participants said the process felt like a “test of commitment,” requiring them or their families to manage logistics and medical tracking on their own.
• Health changes that affect eligibility — New diagnoses, weight changes, or other shifts in health could lead to delays or removal from the list, often without warning.
• Emotional and financial stress — The long wait and uncertainty led to distress. Some people delayed travel or major life plans and faced high out-of-pocket costs for transportation and lodging.

How To Navigate Obstacles to Kidney Transplant

While the transplant journey can be difficult, being prepared and informed may help reduce stress and improve your chances of success. The study highlights the importance of staying engaged and asking questions at every stage.

If you or a loved one is considering a transplant, it can be helpful to:

• Keep records of your appointments, test results, and instructions
• Ask transplant teams for clarity if you’re unsure what’s next
• Talk to your primary care doctor or kidney specialist about changes in your health
• Consider asking a loved one or advocate to help manage paperwork and appointments

Learn more about rare kidney diseases to help you better understand your condition.

Find Your Team

On MyKidneyDiseaseTeam, the social network for people living with kidney disease and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

Do you experience challenges with the transplant evaluation process? What tips do you have for others? Share your experiences in a comment below, start a conversation on your Activities page, or connect with like-minded members in Groups.