Qsource ESRD Network Expands Kidney Transplant Opportunities for Older Adults Through Targeted Education

Patient-centered education and provider collaboration help more adults aged 75 and older gain access to the kidney transplant waitlist.

Age should not automatically determine whether a patient has the opportunity to explore kidney transplantation. Recognizing a gap in how transplant eligibility requirements were being interpreted, Qsource ESRD Network 10 launched a targeted quality improvement initiative to strengthen provider education, address misconceptions, and ensure older adults receive the information and support needed to make informed treatment decisions.

The initiative produced measurable results, increasing the percentage of patients aged 75 and older added to the kidney transplant waitlist from 1.2% to 3.1%, more than doubling the baseline rate.

Identifying a Barrier to Transplant Access

Qsource ESRD Network 10 identified an important misunderstanding among dialysis facility staff regarding kidney transplant waitlist measures. Some facilities were incorrectly applying an age-based exclusion from a Centers for Medicare & Medicaid Services (CMS) payment-related quality measure to the Network's transplant quality improvement initiative.

As a result, patients aged 75 and older were sometimes overlooked for transplant education and referrals, even when they might have been appropriate candidates for evaluation.

While age can be one consideration in determining transplant eligibility, it should not be the sole deciding factor. A patient's overall health, functional status, and personal goals are essential to determining whether transplantation may be an appropriate treatment option.

Turning Provider Education into Patient Opportunity

To address this gap, Qsource ESRD Network 10 worked with dialysis facilities to strengthen staff knowledge, improve patient education, and encourage more inclusive conversations about transplant options.

The Network introduced the Knowledge Assessment of Renal Transplantation (KART) 2.0, a validated assessment that helps dialysis teams identify knowledge gaps related to transplant eligibility, referrals, and waitlisting.

The Network also developed patient-centered educational resources, including Kidney Transplant and Older Adults and What to Do If You Were Denied for Age. These materials help patients and providers better understand transplant eligibility, encourage patient self-advocacy, and reinforce the importance of individualized treatment decisions.

Ongoing education through the Network's monthly Transplant Lunch & Learn webinars further supported dialysis teams with expert perspectives and practical information about transplant referrals, evaluation, and maintaining waitlist readiness.

Together, these efforts helped shift the focus from assumptions about age to meaningful conversations about each patient's health, preferences, and treatment goals.

Measurable Improvement in Transplant Waitlisting

The results demonstrate the value of targeted education and collaboration in addressing barriers to care.

• 12 to 39 patients: The number of adults aged 75 and older added to the kidney transplant waitlist increased from 12 at baseline to 39 following the intervention.
• 1.2% to 3.1%: The proportion of newly waitlisted patients aged 75 and older more than doubled.
• 1,012 to 1,271: The total number of patients added to the kidney transplant waitlist increased during the measurement periods.

As of March 2026, the improvement in the proportion of older adults added to the waitlist was statistically significant, demonstrating meaningful progress in expanding transplant opportunities for this population.

Keeping Patient Choice at the Center of Kidney Care

This success highlights the importance of looking beyond quality measures to understand how clinical practices affect individual patients. By identifying a misunderstanding, strengthening provider knowledge, and creating accessible educational resources, Qsource ESRD Network 10 helped remove an unnecessary barrier to transplant consideration.

The Network will continue reinforcing age-inclusive transplant education and sharing resources with dialysis facilities to support informed, individualized treatment decisions.

For Qsource ESRD Networks, the goal remains clear: ensure every patient has the knowledge, support, and opportunity to explore treatment options that align with their health needs and personal goals.

Through education, collaboration, and a commitment to patient-centered care, Qsource continues working to improve access, strengthen the kidney care community, and help patients live well with kidney disease.

Discover how Qsource ESRD Networks partners with dialysis providers to strengthen quality of care, improve clinical outcomes, and support patients and care partners across the ESRD continuum. Learn more about their expertise and the impact they’re making in their communities.