Kidney Transplant

To be eligible for a kidney transplant, candidates must meet specific criteria and be in good overall health. Guidelines align with federal standards and insurance requirements. 

A patient may not be eligible for a kidney transplant if they have an active infection, another life-threatening disease, such as cancer, or severe heart or lung disease. Clinical teams assess patients on an individual basis to determine candidacy.

Clinical considerations
Factors that may impact transplant candidacy may include, but are not limited to: 

• Heart health: Heart function and history of heart disease.

• Other medical conditions: Current health issues such as cancer, active infections or severe lung disease.

• Body weight: Weight-related factors that may affect surgery and recovery.

• Overall health and age: Physical condition and the ability to tolerate surgery.

• Support system: Having family or friends to assist with recovery, appointments and daily medications.

• Medical history: History of substance use, the ability to follow medical advice and mental health management.

A kidney transplant can be obtained two ways:

• Deceased donation: Patients receive a kidney from a donor who has been declared brain dead or has an irreversible brain injury. The person is a registered organ donor or family members consented to donation.

• Living renal donation: A relative, friend or loved one may offer to donate a kidney. Where available, we provide support for living donors throughout the process.

Patients may request a transplant evaluation. You will be asked to provide:

• Demographics and insurance information

• Dialysis information

• Name and phone numbers of current doctors

• Medical history

The evaluation involves a standard set of tests, including labs and imaging, to assess health and determine if transplantation is a viable option. These tests may include:

• Blood tests – Assessments of physical condition.

• Tissue typing – A blood test to find a donor kidney that matches and provides information about the immune system.

• Colonoscopy – Screening for colon cancer for those over age 45.

• Chest X-ray – Assessment of heart size and lung abnormalities.

• Voiding cystourethrogram (VCUG) – Assessment of the lower urinary tract function.

• Abdominal ultrasound – Examination of the kidneys, liver and gallbladder for cysts, stones or other abnormalities.

• TB skin testing – Testing for exposure to tuberculosis.

• Gynecological exam – Required for all women. Mammograms are also required for women over age 40.

• Pulmonary function studies – Performed for those with a history of lung disease or tobacco use.

• Cardiac tests – Assessment of heart function via echocardiogram and electrocardiogram. A stress test and a cardiac catheterization may be performed if needed.

• Physical examination – Assessment of overall condition.

• Clinic consults – Meetings with a dietitian, finance counselor and physician.

The new kidney may start producing urine immediately or it may take time. If the new kidney does not work right away, dialysis will be necessary until it does.

• Hospital stay: After your transplant, you will remain in the hospital for a period of time determined by your care team. 

• Follow-up appointments: You will follow up with nursing and nephrology staff to ensure your new kidney remains healthy. Clinic schedules vary based on your nephrologist’s recommendations. You will need to have lab work done before each clinic visit. Tests may include renal scans, ultrasounds and kidney biopsies.

• Medications: Post-transplant, you will be on medications to manage the immune response to your new organ. These are taken for as long as the transplanted kidney is functioning. You may also be prescribed medication to manage blood pressure, glucose, cholesterol and other conditions.

Maintaining a healthy lifestyle after transplant supports long-term kidney health. This includes exercising, eating a balanced diet and maintaining a healthy weight. You must take medications as prescribed, attend all clinic visits and report any side effects to the transplant team. You can assist your team by keeping records of your blood pressure, blood sugar, weight, temperature and pulse. 

Return to work or school depends on your kidney function and response to medication. Your care team will advise you on the appropriate timeline for resuming your activities.