Clinical Utility of Standardized Genetic Testing in Kidney Transplant Candidate Evaluation

Background: Genetic testing is increasingly used in the evaluation of kidney transplant (KT) candidates, yet its direct association with transplant-related outcomes remains unclear. This study assessed whether genetic test results are associated with key steps in the KT process. Methods: In this observational cohort study, 270 KT candidates underwent standardized genetic testing between January 2021 and November 2024. The outcomes, including waitlisting and transplantation, were compared between candidates with and without positive results. Primary outcomes assessed clinical utility during transplant evaluation, including diagnostic reclassification of end-stage kidney disease (ESKD), effects on living donor evaluation, and genetic counseling. Secondary outcomes included waitlisting, transplantation, and post-transplant allograft function (estimated glomerular filtration rate). Results: = 0.06, respectively). Conclusions: -associated risk. Testing clarified disease etiology, informed recipient and family counseling, and supported safe living donor selection without affecting waitlisting. Integrating genetic testing into transplant evaluation may enhance precision medicine and transplant care.