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.