I too knew couple of people who were on a waiting list. One thing that you are apparently not aware of is that because of the damage to the body caused by the loss of kidney function and the medications that are given most people needing a kidney transplant will appear to be obese. Fluid retention and steroids can cause a skinny person to swell up like a balloon. Most people who have only recently lost the use of their kidneys may look thin but not for long. A few rare ones will remain looking like they are at normal weight.

My wife has a 60-ish acquaintance sadly experiencing declining health because of increasing severity of kidney failure. She's went to the local (prominent) medical school for a second opinion and received a consistent message that she was not a candidate for a transplant and wouldn't be put on a list. The reason she was told was because of her age and health profile, most significantly her nearly lifelong obesity.

Yes, patients are evaluated in terms of likelihood of success. A person with cancer would be lower on the list than a young person in otherwise good health. Other than the kidney disease, I mean. Alcoholism and drug abuse can take a person off the list entirely.

I'm surprised at that verdict, Elmer. A member of my pulmonary rehab group had Wegener's disease. This can destroy the lungs and kidneys. He ended up on dialysis and on a kidney transplant list. He was in his mid-late 60's.

He got his kidney and did very, very well until he became depressed (he had had problems with this in the past), and started eating anything that couldn't run faster than he could, put on a huge amount of weight and ended up dying of a heart attack, about 5-6 years after he got his kidney. Perhaps it depends on the part of the country. I believe Steve Jobs went to Tennessee. Perhaps it's harder to get an organ in CA.

I do know that some patients waiting for a transplant move to a state with no motorcycle helmet laws. Those riding helmetless are known locally as "organ donors" as many die of head injuries and their organs are then quite valuable.

My old friend's daughter was on the list for 2 1/2 years. She had polysystic kidney disease, was 40 when kidneys finally shut down. Kidneys were bigger than footballs and had to be removed even though they like to keep one because it helps the transplanted one when received. Her health had never been robust due to myriad other problems but she did receive a kidney. There were many people tested but no one matched. So many more factors go into matching than I can even remember including number of pregnancies, etc.! Things you would never imagine! My friend has been through unimaginable times.

https://www.kidney.org/atoz/content/transplant-waitlist

A former co-worker has been in the waitlist for almost 5 years now. He is in his 50’s, and was in reasonably good health prior to his kidney failure. He keeps hoping he will be called at any moment. He does home dialysis but it’s tough on him and his family to plan anything very far from home, hoping he will get ‘the call’. And we are very close to Tennessee. Don’t think geography makes all that much difference. His family members were all tested long ago. He has no living siblings (his only sister died several years ago). Those of who know him well have hoped and prayed for him for so long.