{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:50:43Z","timestamp":1791345043441,"version":"4.3.1"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplant programs may remove high\u2010risk patients from the national transplant waiting list to mitigate peri\u2010transplant complications and enhance overall post\u2010transplant survival. The phrase \u201ctoo sick,\u201d frequently reported to the Organ Procurement and Transplantation Network (OPTN) as a reason for removal, lacks precision and specificity. Furthermore, there is limited information regarding the survival outcomes of patients who have been delisted and are consequently ineligible for a kidney transplant. In this study, we describe the specific reasons for delisting and investigate subsequent survival outcomes after being removed from the waiting list.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from patients 18 years and older removed from the renal transplant waiting list between January 2011 and December 2015. Delisting categorization divided patients into a medical group (removed for clinical reasons such as cardiovascular disease, malignancy, or severe iliac calcification) and a psychosocial group (removed for issues such as patient request, non\u2010compliance, insurance loss, or loss of contact). The primary endpoints were 5\u2010year survival and restricted mean survival time (RMST) at 5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 240 eligible patients, 124 patients (51.7%) were delisted for medical reasons and 116 (48.3%) were delisted for psychosocial reasons. Upon investigation, the primary reason for removal from the transplant waiting list among the medical group was cardiovascular (CV)\u2010related comorbidities (44, 35.5%). 55% of the total number of patients delisted survived for 5 years. Patients delisted for medical reasons exhibited a 5\u2010year survival rate of 43% and a RMST of 3.3 years. Specifically, patients delisted for CV\u2010related reasons had a 5\u2010year survival rate of 44%. In contrast, patients delisted for psychosocial reasons had a higher 5\u2010year survival rate of 70% and a longer RMST of 4.31 years (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt; 0.001). At 5 years following delisting, patients diagnosed with coronary artery disease (CAD) exhibited a 51% survival rate, which was significantly lower compared to those without CAD with a survival rate of 57% (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.046).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cardiovascular disease remains the leading cause of delisting from the kidney transplant waiting list. However, many delisted patients demonstrated longer survival than expected. Further studies are needed to clarify the impact of delisting decisions on outcomes and to guide more informed, patient\u2010centered transplant practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70673","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:16:54Z","timestamp":1788567414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delisting From the Kidney Transplant Waiting List: Impact on Patient Survival"],"prefix":"10.1111","volume":"40","author":[{"given":"Parker","family":"Schimmers","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Cooper","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley","family":"Glime","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayham","family":"Asassfeh","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Arpali","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ty","family":"Dunn","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Cooper","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badi","family":"Rawashdeh","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03686.x"},{"issue":"4","key":"e_1_2_11_3_1","first-page":"14","article-title":"A Bibliometric Analysis of the Most Cited Journal Articles in Kidney Transplantation","volume":"15","author":"Rawashdeh B.","year":"2023","journal-title":"The Cureus Journal of Medical 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