The 2026 Early Steps to Transplant Access Registry (E-STAR) Annual Data Report by the Regenstrief Institute's Transplant Research for Enhancing Access Team (TREAT) provides critical insights into challenges patients face before being added to kidney transplant waiting lists.The report reveals that while referral rates for transplant evaluation increased from 24.3% in 2015 to 33.4% in 2023, evaluation initiation within three months of referral dropped significantly from 42% to 24.3%.

Waitlisting within six months of evaluation remained stable at 26%, but significant variation exists across transplant centers, with some facilities reporting as low as 1.6% and others up to 76.6% for timely evaluations.

The study emphasizes that many barriers to transplantation occur before patients reach the waiting list, highlighting the need for improved communication and support throughout the process.

E-STAR's comprehensive data from 37 centers across 13 states aims to identify systemic issues and generate actionable strategies to enhance access to kidney transplants, particularly during early stages of care.

The findings underscore the importance of addressing disparities in transplant referral and evaluation processes to improve outcomes for patients with end-stage renal disease.