Accepted for/Published in: JMIR AI
Date Submitted: Mar 17, 2025
Date Accepted: Sep 20, 2025
Date Submitted to PubMed: Sep 21, 2025
Transparency in Kidney Transplant Recipient Selection Criteria: A Nationwide Analysis Using AI
ABSTRACT
Background:
Choosing a transplant program impacts a patient’s likelihood of receiving a kidney transplant. Most patients are unaware of the factors influencing their candidacy. As patients increasingly rely on online resources for healthcare decisions, this study quantifies the available online patient-level information on kidney transplant recipient (KTR) selection criteria across U.S. transplant centers.
Objective:
Quantify the available online patient-level information on kidney transplant recipient (KTR) selection criteria across U.S. transplant centers.
Methods:
A cross-sectional study using natural language processing and a large language model was conducted to review the U.S. kidney transplant centers websites from June to August 2024. Links were explored up to three levels deep, and information on 31 guideline-recommended selection criteria was collected from each transplant center.
Results:
A total of 255 U.S. kidney transplant centers were analyzed, comprising 10,508 webpages and 9,113,753 words. Among the kidney transplant guideline-recommended selection criteria, only 2.6% of the information was present on the transplant centers webpages. Socioeconomic and behavioral criteria mentioned more than those related to patient medical conditions and comorbidities. Of the 31 criteria, finances and health insurance was the most frequently mentioned, appearing in 25.5% of the transplant centers. Other socioeconomic and behavioral criteria such as family and social support systems, adherence, and psychosocial assessment, were addressed in less than 4%. No information was found in any webpage for 14 of the criteria. Geographically, disparities in reporting were observed, with the South Atlantic division showing the highest number of distinct criteria, while New England had the fewest.
Conclusions:
Most online patient-level KTR selection criteria are unavailable. The lack of transparency in the pre-waitlist process involving KTR selection criteria may limit patients from choosing their most suitable transplant center and successfully receiving a kidney transplant.
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