Monday, June 22, 2026

Most people seeking a kidney transplant never reach the waitlist

Reducing barriers in the evaluation process may improve access to lifesaving procedures

NYU Langone Health / NYU Grossman School of Medicine

Nearly half of Americans with kidney failure who are referred for transplantation never begin the process required to be considered for a new organ, a new study shows, while less than a fifth actually complete the assessment and get on the waitlist.

While experts have studied what happens once people make it onto the list, little attention has been paid to challenges in making the waitlist in the first place, the study authors said.

Led by NYU Langone Health researchers, the national study of 720,348 patients referred for the procedure found that those who were unmarried, had severe obesity, or lived in rural areas were less likely to start or complete an evaluation at a transplant center and make the waitlist. Older, Spanish-speaking, and poorer patients were especially unlikely to progress, as were those treated at smaller centers or at programs in the South. Results showed that only 19 percent of referred patients completed the evaluation, and 48 percent never even started it.

“Our findings suggest that a substantial proportion of people who need a new kidney fall out of the process long before they reach the waitlist, let alone make it to the operating room,” said study lead author Conor Donnelly, MD. “Which transplant center you go to, where you live, and even whether you are married all appear to influence your chances of moving forward to the waitlist for a new kidney.” Dr. Donnelly is a resident and PhD student in NYU Grossman School of Medicine’s Department of Surgery.

Much of this variation may stem from the complexity of the process, which can be difficult for patients to navigate, said Dr. Donnelly. Once a referral for a kidney transplant is made, the patient undergoes a battery of tests to provide a detailed picture of their health. These tests may include blood work, chest imaging, and cancer screenings, often requiring the patient to make several visits over a period of months while also attending dialysis sessions each week. Only after this process is completed and the candidate is approved are they placed on the waitlist.

Smaller centers with fewer resources and transplant slots may be more selective and risk-averse than larger programs, the researchers said. Also, candidates who are unmarried or lack strong social support may struggle to make repeated trips for evaluations and follow-up appointments. This may help explain why people living in urban areas, where transplant centers are more numerous and often closer to home, are more likely to move forward in the process.

Publishing online June 20 in the Journal of the American Society of Nephrology, the study is the largest and most detailed to date to examine where patients drop out of the kidney transplant process, according to the authors. It is simultaneously being presented at the American Transplant Congress, the annual joint meeting of the American Society of Transplantation and the American Society of Transplant Surgeons.

For the study, the team used Epic Cosmos, a dataset of more than 300 million electronic health records from over 1,850 hospitals, including more than a third of all US transplant centers. The researchers focused on adults referred for a kidney transplant between 2014 and 2025, tracking each patient through four stages: referral, evaluation, waitlist, and transplant.

Using statistical models, the researchers analyzed how a wide range of factors, from age and sex to geographic location and medical history, affected the chance of moving from one step to the next. They also examined social vulnerability—a measure of how a person’s living conditions, such as poverty, lack of transportation, and unstable housing, may disadvantage them when they’re trying to get care.

“These results demonstrate that finding ways to reduce barriers to both evaluation and waitlisting could help expand much-needed access to kidney transplantation,” said study co-senior author Allan B. Massie, PhD, an associate professor in the Departments of Surgery and Population Health at NYU Grossman School of Medicine. “Providing patients with better education and support to help them navigate the complex and sometimes grueling process would be a good start.”

“Our findings highlight the need to better support patients in progressing from referral to the waitlist, where many possibly eligible individuals are not ultimately listed,” said study co-senior author Michal A. Mankowski, PhD.

Dr. Mankowski, an assistant professor in the Department of Surgery at NYU Grossman School of Medicine, said the team next plans to extend this research approach to other types of organ transplants, for which the path to the waitlist can look very different.

NYU Langone Health provided funding for the study.

Along with Drs. Donnelly, Massie, and Mankowski, NYU Langone researchers involved in the study were Suhani Patel, MPH; Syed Ali Husain, MD, MPH; Sommer E. Gentry, PhD; Bonnie E. Lonze, MD, PhD; Sunjae Bae, MD, PhD; Babak J. Orandi, MD, PhD; Mara A. McAdams DeMarco, PhD; and Dorry L. Segev, MD, PhD. Other study co-investigators were Rachel Patzer, PhD, MPH, at Indiana University in Indianapolis, and David Axelrod, MD, at University Hospitals in Cleveland.

Dr. Orandi has served on an advisory board for the pharmaceutical company Boehringer Ingelheim. NYU Langone Health is managing the terms and conditions of this relationship in accordance with its policies and procedures.

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About NYU Langone Health
NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient, Inc. has ranked NYU Langone No. 1 out of 118 comprehensive academic medical centers across the nation for four years in a row, and U.S. News & World Report recently ranked four of its clinical specialties number one in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across seven inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. The system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.

Media Inquiries
Shira Polan
212-404-4279
Shira.Polan@NYULangone.org

Journal

Journal of the American Society of Nephrology

Subject of Research

People

Article Title

Evaluating Barriers to Kidney Transplantation in the United States

Article Publication Date

20-Jun-2026

COI Statement

Sunday, June 21, 2026

See the world of Stonehenge from your sofa this solstice

The original exhibition ran at the British Museum in 2022

University of Reading

A new free online experience allowing anyone in the world to step inside the world of Stonehenge exhibition and explore thousands of years of history launches today (Sunday, 21 June).

The Virtual World of Stonehenge, developed by researchers at the University of Reading and the British Museum, gives users an immersive digital tour of one of the most celebrated museum exhibitions in recent years. The original World of Stonehenge exhibition ran at the British Museum in 2022, attracting more than 190,000 visitors and bringing together over 400 objects from 36 institutions across Europe.

Timed to release alongside the summer solstice, the new virtual version goes well beyond a simple recreation of the gallery. Users can go inside Stonehenge itself and watch it change through time, explore Neolithic flint mines at Grimes Graves, and discover rarely seen prehistoric objects through animation, soundscapes and interactive content. The experience is free to access via the British Museum website and works on desktop computers, tablets and phones.

Professor Duncan Garrow, Professor of Archaeology at the University of Reading, said: "The original exhibition brought together an extraordinary collection of prehistoric objects, many of which had never been displayed together before. Now anyone, anywhere they are, can not only see those objects but understand the world of Stonehenge and experience how it looked and felt thousands of years ago. We hope it brings prehistoric Britain to life in a completely new way."

Dr Neil Wilkin, at the British Museum, said: “This has been an amazing opportunity to think about the future of virtual museum exhibitions, not just at the British Museum but everywhere across the world”.

Laser-scanning leaves, bracelets and crumbs

The project was funded by UK Research and Innovation and builds on AHRC-funded research led by British Museum curator Dr Neil Wilkin, in partnership with Professor Duncan Garrow at the University of Reading. The team worked with the University of Southampton and digital heritage specialists ArtasMedia to transform a 3D laser scan of the original gallery, captured during the final weeks of the exhibition in 2022, into a fully interactive online experience.

A particular focus of the project was making the stories behind lesser-known prehistoric objects more accessible. These include a 6,000-year-old elm leaf, a woven cow-hair bracelet, and the remains of a prehistoric feast, all of which are brought to life through new digital content developed specifically for the virtual exhibition.

The launch coincides with the summer solstice, the moment when Stonehenge's alignment with the rising sun has drawn people to the site for thousands of years.

The Virtual World of Stonehenge is free to access from Sunday 21 June: The World of Stonehenge: University of Reading and British Museum

FOR REPORTERS, USE CLOUD TOUR BEFORE 21 JUNE

New battery management system makes electric car batteries safer and more durable

In the EU project Nemo, a research team involving TU Graz has developed new models that make battery management systems significantly more intelligent. They detect damage at an early stage and increase the service life of electric car batteries

Graz University of Technology

image:
Electric car batteries can be monitored much more effectively whilst in use thanks to the upgraded battery management system.
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Credit: VSI - TU Graz

Just as an orchestra needs a conductor, a battery management system (BMS) controls the power storage of an electric vehicle. However, up to now the monitoring is only based on the voltages, currents and temperatures of the individual battery cells. Their ageing or possible damage can only be checked externally using complex calculations. In the EU project Nemo, Graz University of Technology (TU Graz), the Vrije Universiteit Brussel and partners from industry have developed intelligent models and algorithms that enable the safety, service life and performance of batteries to be monitored directly in the vehicle’s system.

Avoiding dangers

“The battery management system is an important tool for operating electric vehicles more safely and sustainably,” says Christoph Drießen from the Vehicle Safety Institute at TU Graz. “If we recognise faults and damage to individual battery cells at an early stage via the BMS, many dangers can be avoided. And thanks to the monitoring of the ageing process of each individual cell, their service life can also be extended substantially through intelligent control.”

The team at the Vehicle Safety Institute at TU Graz focused primarily on the safety aspects of the batteries. To this end, the researchers at the institute’s Battery Safety Center examined battery cells that were mechanically deformed, for example to simulate parking damage. They used this laboratory data to train models and algorithms they had developed themselves so that the BMS can recognise damage independently and indicate when maintenance is required. In order to obtain the necessary data from inside the cell, the team is using new sensor technology known as electrochemical impedance spectroscopy (EIS), which measures the electrical resistance inside the cells in the vehicle.

Internal findings on ageing

In addition, the Graz researchers developed a model that predicts the change in physical volume of the cells during charging and discharging. As excessive expansion increases the mechanical pressure in the battery pack and can lead to cracks and deformations, this model helps to minimise the risk of internal short circuits and thermal peaks.

The algorithms and models pertaining to service life and ageing were developed at the Vrije Universiteit Brussel. Their implementation in the BMS offers clear advantages over previous models or external checks. “Up to now, a test only showed how much the capacity has decreased compared to the original battery condition,” says Christoph Drießen. “But the new models also give us an insight into the changes within the cells as they age. This enables adjustments that are beneficial for performance, service life and safety.”

Demonstrator as a model for series production

Despite the numerous new functions, the enhanced BMS would not be significantly larger or heavier than before. For the additional EIS measurements, however, additional sensors and a correspondingly adapted integration into the BMS are required.

In order to further demonstrate the developed technologies, a follow-up project will work on their continued development and transfer towards industrial application. A demonstrator at module level has already been set up for this in the current project.

The project was Co-funded by the European Union. Additional funding came from the Swiss State Secretariat for Education, Research and Innovation. In addition to TU Graz and the Vrije Universiteit Brussel, Infineon Technologies Austria, Ingenieurgesellschaft Auto und Verkehr (IAV) and the Centre Suisse d’Electronique et de Microtechnique (CSEM) were on board as hardware and software providers as well as TTTech for the cloud implementation and ICONS as partners.

As part of the development of the battery management system, battery cells were subjected to a number of tests.

Credit

VSI - TU Graz

Journal

Journal of Power Sources

DOI

10.1016/j.jpowsour.2026.240029

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Development of a P2D-based model for battery swelling prediction under mechanical constraints

Cotton’s roots trace to Yucatan Peninsula, where wild gene pool runs deepest

Iowa State University

Wild cotton versus modern cotton — image:
Wild cotton, on left, has short, brown, and coarse fibers, while modern domesticated cotton has white, fine and abundant fibers. A new study led by Iowa State University scientists identified the northwestern Yucatan Peninsula in Mexico as the original source of domesticated cotton.
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Credit: Corrinne Grover/Iowa State University

AMES, Iowa – There’s nothing like this in nature, Jonathan Wendel said as he showed a visitor in his Bessey Hall office the long white puffs billowing from a cotton boll – the protective flower capsule of the plant cultivated by humans for thousands of years. In the wild, cotton bolls are far smaller and hold darker, coarser and shorter fibers.

How did we get from there to here? Wendel, a distinguished professor of ecology, evolution and organismal biology at Iowa State University, has been asking that question for decades.

“This is my 40th year on faculty, and I came here with this project in mind. And it took 40 years to develop the resources, tools and technologies to solve the problem,” he said.

Wendel and a team of 19 co-authors outlined an answer in a paper published last month in the Proceedings of the National Academy of Sciences, showing that newly collected wild plant samples and advanced analysis of genomic sequencing data confirm modern cotton was domesticated from a diverse population native to Mexico’s Yucatan Peninsula.

Tracing the lineage of cotton gives scientists a better understanding of how plants evolve. But given the plant’s significance as a crop – cotton remains the most common source of natural textiles, by far – there are also direct practical benefits. Knowing where cotton came from is a genetic treasure map, pointing where to look for valuable traits such as disease resistance or salt tolerance that were lost along the way as farmers bred for other qualities.

“When humans domesticate a plant, you pick from a big population and everything else is left behind. Do that for 1,000 generations, and you have a very narrow genetic base,” Wendel said. “So we’re very interested in that wild genetic diversity. We want to know what’s still out there.”

Collections years in the making

Pinpointing modern cotton’s home in the Yucatan was not a surprise. Earlier studies by Wendel, a prominent expert in cotton genetics, used less precise methods to suggest the peninsula curling to the north in southeastern Mexico was a likely origin of the plant’s domestication – a process that began about 5,000 years ago.

The advent of quick, affordable genome sequencing put a more definitive determination within reach, if Wendel and his colleagues could gather a wide enough sampling of wild specimens. He’s been collecting wild cotton his whole career, scouring herbarium shelves and Caribbean coastlines for variants.

“If everything you're looking at has crazy new variation, you clearly haven't reached saturation. But if the next 10 things look like the last thing you picked and everything’s forming a nice tight cluster, well, why bother to keep doubling up?” Wendel said.

Cotton plants steadily gathered over the years were important contributions to the study, but systematic collection in known wild populations was the linchpin. Corrinne Grover, an Iowa State research scientist and assistant adjunct professor in ecology, evolution and organismal biology, led new specimen sequencing and analysis of the complex data.

“Our collaborators did an amazing job sampling across the Yucatan strategically, and once we had that sequencing data it was very clear that’s where it came from,” she said.

Researchers compared hundreds of cotton genomes in different ways to validate their findings, including quantifying the differences between individual genomes and mapping which are most similar. That analysis linked domestic cotton genomes most closely to the specimens from the northwest corner of Yucatan, Grover said.

“Essentially, we're building huge data-powered genealogies of these plants, just like you could with people,” Wendel said.

Mining old plants for new benefits

After cultivated cotton spread out of northwestern Yucatan, it went on to dominate the worldwide population, crowding out other varieties independently domesticated in South America, Africa and India. The species native to Mexico – Gossypium hirsutum, also called upland cotton – accounts for about 90% of cotton plants today, a takeover researchers say was based on gradual improvement as opposed to dramatic mutations.

The diversity left behind in the wild during thousands of years of selective human breeding is most concentrated in cotton’s ancestral home because domestication creates a genetic bottleneck, narrowing the gene pool in successive generations. The genomes of two random wild cotton plants from northwestern Yucatan have on average twice as many genetic differences as two random modern cultivars, researchers found.

“As it turns out, cultivated cotton was poured out of a very small genetic bottleneck,” Wendel said.

The benefits of that diversity are obvious when you walk through a greenhouse where both domestic and wild cotton are growing, Grover said. The shorter, more compact domestic plants have fluffier bolls, but their wild brethren are often in better health overall.

“We know there are genetic traits in wild populations that could be useful if we can figure out what they are and get them into domesticated cotton,” she said. “Now we have all this data from the Yucatan, and it’s ready to be mined.”