{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:19:47Z","timestamp":1787681987230,"version":"build-2784847793"},"reference-count":12,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Risks of kidney failure among prior living kidney donors (LKDs) are low, but an updated analysis of the impact of donor allocation priority on waiting times accounting for allocation changes and race has not been documented.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using national UNOS data, we compared transplant rates, waiting time, and time on dialysis for prior LKDs with matched controls.\u00a0\u00a0Waiting time was calculated based on initial registration and end waitlist date.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Transplant rate was 86.2 per 100 person years for LKD and 20.4 for matched controls (\n p<\/jats:italic>\n \u00a0<\u00a00.001) corresponding to 83% of prior LKDs\u00a0transplanted compared to 50% of matched controls (\n p<\/jats:italic>\n \u00a0<\u00a00.001).\u00a0 Median waiting time was 93 (27\u2013371) days in the LKD group versus 692 (233\u20131351) days in\u00a0the\u00a0matched\u00a0control\u00a0group\u00a0(\n p<\/jats:italic>\n \u00a0<\u00a00.001).\u00a0LKD waiting\u00a0time pre\u2010\u00a0and post\u2010implementation of the \u201cnew\u201d Kidney Allocation System (KAS) was\u00a0133 (42\u2013516) versus 67 (19\u2013226) days, (\n p<\/jats:italic>\n \u00a0<\u00a00.001).\u00a0For LKDs, 56% were on dialysis prior to listing and 61% prior to transplant compared to 66% and 82% in controls,\u00a0(both\n p<\/jats:italic>\n \u00a0<\u00a00.001).\u00a0Time on dialysis among\u00a0LKDs\u00a0post\u2010KAS\u00a0was\u00a0comparable\u00a0(pre\u2010KAS: 547 (259\u20131352) versus post\u2010KAS: 461 (231\u2013942) days,\n p<\/jats:italic>\n \u00a0=\u00a00.06). Waiting times were comparable according to race and ethnicity, but\u00a0Black LKDs were\u00a0more often on dialysis at\u00a0the\u00a0time of listing\u00a0(Black 61%\u00a0vs. white: 52%,\n p<\/jats:italic>\n \u00a0=\u00a00.02), and\u00a0time on dialysis was 36% (+155 days) longer in Black versus white LKDs\u00a0(\n p<\/jats:italic>\n \u00a0=\u00a00.0002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n LKD allocation priority results in a higher transplant rate and significant reduction in waiting time\u00a0compared to matched controls,\u00a0which improved post\u2010KAS\u00a02014.\u00a0 Concerning, more than half of LKDs are on dialysis prior to listing\u00a0and\u00a0transplant\u00a0with no substantial improvements in the post\u2010KAS era.\u00a0 Black LKDs\u00a0experience lower transplant rates, 36% longer dialysis time compared to white LKDs,\u00a0and are more likely to be on dialysis prior to listing and\u00a0transplant.\u00a0 Improved monitoring\u00a0of LKDs\u00a0and earlier transplant\u00a0referrals\u00a0are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ctr.70618","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:20:06Z","timestamp":1785342006000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Keeping Our Promise: Expedited Allocation for Prior Living Kidney Donors and Trends in Waiting Times According to Race"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9366-5604","authenticated-orcid":false,"given":"Syed Saad","family":"Mujtahedi","sequence":"first","affiliation":[{"name":"Section of Abdominal Organ Transplantation, Department of Surgery Atrium Health Wake Forest Baptist Hospital, Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"McCracken","sequence":"additional","affiliation":[{"name":"Section of Abdominal Organ Transplantation, Department of Surgery Atrium Health Wake Forest Baptist Hospital, Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Webb","sequence":"additional","affiliation":[{"name":"Section of Abdominal Organ Transplantation, Department of Surgery Atrium Health Wake Forest Baptist Hospital, Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2262-6341","authenticated-orcid":false,"given":"Oliver","family":"Whittington","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Virginia Commonwealth University School of Medicine Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Farney","sequence":"additional","affiliation":[{"name":"Section of Abdominal Organ Transplantation, Department of Surgery Atrium Health Wake Forest Baptist Hospital, Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Orlando","sequence":"additional","affiliation":[{"name":"Section of Abdominal Organ Transplantation, Department of Surgery Atrium Health Wake Forest Baptist Hospital, Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vince","family":"Casingal","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery Atrium Health Carolinas Medical Center, Wake Forest University School of Medicine\u00a0 Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7634-094X","authenticated-orcid":false,"given":"Robert J.","family":"Stratta","sequence":"additional","affiliation":[{"name":"Section of Abdominal Organ Transplantation, Department of Surgery Atrium Health Wake Forest Baptist Hospital, Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5824-1727","authenticated-orcid":false,"given":"Colleen","family":"Jay","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery Atrium Health Carolinas Medical Center, Wake Forest University School of Medicine\u00a0 Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.13452"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200108000-00004"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199508103330601"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16463"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2016.07.001"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14557"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.285141"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000920"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01360216"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.10.014"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014030302"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13061"}],"container-title":["Clinical 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