A national study from NYU Langone Health highlights how few kidney transplant candidates reach the waitlist after referral. The report found that only about 19% of American patients diagnosed with kidney failure complete the process to become candidates. The finding spotlights a multi-step access barrier—between diagnosis or referral and official listing—that can prevent otherwise eligible patients from accessing transplantation. For transplant networks and health-system stakeholders, the next pressure point is to identify where drop-off occurs and which interventions can increase successful listings. The report’s framing suggests the problem is systemic rather than isolated, making it relevant for policy, clinical workflows, and resource planning across nephrology and transplant programs.