THE ACCESS — AN ATLAS OF THE U.S. DIALYSIS SYSTEMPLATE III — FIRST STATE — 07|2026

The Transplant Map

A DRAWN MAP · THE DOOR OUT OF THE CHAIR

How a person gets from the chair to an organ, and what happens to their coverage after. The gate is in the clinic: the plan of care must carry a transplant referral status — or the documented why-not — every year. The wait is national machinery: time credited from dialysis start, organs matched by KDPI and EPTS. And the door swings both ways: ESRD-only Medicare ends thirty-six months after a successful transplant, the immunosuppression outlives it, and a failed graft returns the traveler to the chair with no new waiting period.

HOW TO READ · BOX = A STATION ON THE ROUTE · ARROW = THE MOVE · DASHED = THE BYPASS OR THE WAY BACK · DIAMOND = A DECISION · HAIRLINE REGION = A NEIGHBORHOOD OF THE MACHINERY · LAST VERIFIED 2026-07-10
AN ATLAS OF THE U.S. DIALYSIS SYSTEMWIDE GRAMMAR — CHAIR TO ORGANPLATE III
The Transplant MapFIRST STATE · ED. 001 · 07|2026
AFTER THE ORGANTHE WAIT — THE NATIONAL MACHINERYTHE TRANSPLANT CENTERTHE CLINIC — WHERE THE MAP LEAVES FROMREFERREDNOT A CANDIDATE — WHYDOCUMENTEDPREEMPTIVE REFERRAL —THE BYPASSLISTEDDEFERRED OR DECLINED —RE-REFERRAL POSSIBLEORGAN ACCEPTEDAT 36 MONTHSIF THE GRAFT FAILSTHE CHAIRIN-CENTER OR HOMEDIALYSISPLAN OF CARETRANSPLANT REFERRALSTATUSOR RATIONALE — REVIEWEDANNUALLYLATE-STAGE CKDNOT YET ON DIALYSISEVALUATIONMULTIDISCIPLINARYWORKUPOPTN NATIONAL WAITLISTTIME CREDITED FROMDIALYSIS STARTOR GFR 20 OR LESS — KAS2014MATCH RUNKDPI x EPTS + PRIORITYOPO — DECEASED-DONORORGAN RECOVEREDLIVING DONORDIRECT OR PAIREDEXCHANGETRANSPLANTFUNCTIONING GRAFT — OFFDIALYSISIMMUNOSUPPRESSION FORTHE GRAFT'S LIFEPART B 36 MONTHS, THENLIFETIME PART B-IDSINCE 2023 IF NO OTHERCOVERAGEESRD-ONLY MEDICARE ENDS36 MONTHS AFTER ASUCCESSFUL TRANSPLANTGRAFT FAILURERETURN TO DIALYSIS ORRE-LISTRE-ENTITLEMENT — NO NEWWAITING PERIOD
MARGIN — RESERVED FOR THE HAND
KEY
A STATION — WHERE THE TRAVELER IS
A DECISION — REFERRAL OR MATCH
THE MOVE
THE BYPASS / THE WAY BACK
A NEIGHBORHOOD OF THE MACHINERY
THE ACCESS · 07|2026
ED. 001 · DRAWN MAP SRC: 42 CFR 494.90 (V554) · OPTN/HRSA KAS 2014 · CMS PART B-ID (2023) · LAST VERIFIED 2026-07-10
PLATE III · FIRST STATE DRAWN UNDER THE AUTHOR’S DIRECTION · VERIFIED AGAINST THE ATLAS DATASET
AWAITING THE AUTHOR’S PASS PLATE IV