Media release

From: National Indigenous Kidney Transplantation Taskforce (NIKTT)

New study exposes critical waitlisting barriers for First Nations people with kidney failure

This NAIDOC Week, the Medical Journal of Australia has published a Special Issue on Indigenous Health – Carving our path with spirit, strength and solidarity. The issue, led by an all-First Nations editorial team, highlights evidence and solutions created by and for Aboriginal and Torres Strait Islander communities.

Featured in the issue is new research from the National Indigenous Kidney Transplantation Taskforce (NIKTT), a national initiative established to address inequities in access to kidney transplantation for Aboriginal and Torres Strait Islander people.

The NIKTT paper — Am I on the List? — moves beyond simply showing that inequity exists. It provides the first national breakdown of clinician-reported reasons for why patients aren’t waitlisted, revealing where and how the system is failing. The data show that barriers occur at every step — from not starting assessments to being ruled ineligible — and that delays in completing work-up are far more common for First Nations patients.

While clinical reasons like cardiovascular disease and obesity were reported at similar rates across groups, the compounding effects of disrupted or delayed care disproportionately exclude Aboriginal and Torres Strait Islander people from life-saving transplants.

The authors call for targeted, system-wide investment in referral pathways, assessment processes, culturally safe care, and ongoing accountability to close the transplant equity gap. This is the first national analysis of clinician-reported reasons for non-waitlisting, drawing on enhanced data from 26 renal units that care for the majority of First Nations dialysis patients. The findings not only confirm the need for better models of care, they also reinforce the case for implementing Priority 2 of the National Strategy for Organ Donation, Retrieval and Transplantation, which commits to improving transplant access for First Nations people.

NAIDOC Week Call to Action

This year marks 50 years of elevating Indigenous voices through NAIDOC Week. The 2025 theme — The Next Generation: Strength, Vision & Legacy — celebrates the rising leaders building on a legacy of resistance, resilience, and reform. NIKTT’s work embodies this vision by centring Aboriginal and Torres Strait Islander governance in every aspect of kidney care reform and pairing Community leadership with data-driven findings to dismantle structural racism.

Sustained progress now depends on embedding these First Nations-led frameworks across the health system. That requires secure, long-term funding and full implementation of the National Strategy. Stakeholders can help by advocating to ministers and Strategy representatives for continued investment in NIKTT and the Strategy’s delivery, ensuring today’s evidence leads to tomorrow’s equitable, culturally safe care.