Factors associated with transplant workup completion in a regional kidney program in Ontario, Canada: a retrospective cohort study

Introduction Minimizing delays during the pre-kidney transplant workup is critical for patients and providers. We evaluated the factors associated with workup completion times across the processes and key investigations in our program. Methods In this single-center, retrospective cohort study, we included all candidates who initiated their pretransplant workup between January 1, 2019 - December 31, 2022. Patients were allocated, based on their consecutive referrals, alternately to an intensified pretransplant clinic follow-up process with more frequent assessment visits every 4 months during evaluation (Cohort 1), or a single initial assessment with no interim visits until full workup completion (Cohort 2). Follow-up was continued until June 1, 2025. Ethical approval was obtained with waived informed consent. Results In total, 207 patients were allocated to Cohort 1 (n = 94, Age 52.2 ± 14.2 years, 45.7% female) and Cohort 2 (n = 113, Age 56.8 ± 12.1 years, 43.4% female), with no significant demographic differences between cohorts. Cohort 1 demonstrated a significantly shorter median workup duration (12.8 vs. 17.1 (-4.1 months), P = 0.007) and reduced dialysis vintage at the time of transplant decision (22.3 vs. 29.4 (-7.1 months), P = 0.056). Discussion Frequent pre-transplant assessment visits were associated with expedited workup completion and reduced dialysis vintage.