Candidate Evaluation

A kidney transplant is offered to people who have end-stage renal disease or those who are rapidly approaching end-stage renal disease, who would receive a preemptive transplant. The Hume-Lee Transplant Center will perform a comprehensive evaluation to determine your transplant candidacy. Your dedicated team of experts will guide you through the evaluation process. This team includes:

• Transplant nephrologist: This doctor will follow you before and after your transplant. The doctor will complete a physical exam and discuss with you what tests are needed for you to have a transplant.
• Transplant surgeon: This highly specialized doctor will evaluate you prior to surgery and will perform your transplant surgery.
• Transplant coordinator(s): This nurse will discuss transplantation and answer any questions you may have. Coordinators will be your contact before and after your transplant.
• Financial coordinator: This professional will meet with you to discuss your insurance coverage.
• Social worker/psychologist: These professionals meet with you to assess your readiness for a transplant.
• Transplant Pharmacist: This professional will monitor your medications after transplant surgery.
• Transplant Registered Dietician: This professional will assess your nutritional needs and provides education on diet and nutrition.

At the time of your initial appointment, you will meet many of the team members. You will be given a large amount of information that day, and we recommend that you bring a family member or friend with you. The initial appointment may last several hours.

Required Tests

All individuals must have the following tests:

• HLA and blood typing to match a kidney to you
• Laboratory tests for infectious diseases, such as HIV and hepatitis B or C
• Chest X-ray and EKG (electrocardiogram) to be performed at our hospital
• Dental clearance
• Tuberculosis skin test (PPD)
• Pap smear and baseline mammogram (women)

Additional Tests

Additional tests may be required during or after the initial evaluation, depending upon your medical history. Additional tests and images may include:

• Possible ultrasound of your gallbladder to check for gallstones
• Possible voiding cystourethrogram to see if your bladder empties normally
• Heart testing such as echocardiogram, stress thallium test or cardiac catheterization if there is a history of heart disease, any heart-related illnesses or diabetes, or you are over age 50
• Colonoscopy to check for cancer

Once you have completed the medical evaluation and have met the established Patient Inclusion Criteria to be an acceptable candidate for transplant, your information is sent to your insurance company for approval. Once we have obtained financial clearance, your name will be placed on the waiting list. Your transplant coordinator will notify you and your dialysis center or nephrologists.

Listing with UNOS

Once you have completed the tests, medical and surgical evaluation, and approval from insurance has been obtained, your coordinator will present your patient file at the Renal Transplant Selection Committee meeting. This Committee is made up of members of the Transplant Team including transplant surgeons, transplant nephrologists, transplant coordinators, transplant social workers, transplant dietician, transplant pharmacist, transplant psychologist, and others. The results of your testing will be reviewed and discussed to make sure you are an appropriate candidate for transplant. If you are deemed an “appropriate” candidate, your name will be placed on the United Network for Organ Sharing (UNOS) wait list for a deceased donor kidney transplant or you may move forward with living donor transplant if a living donor has been identified. The different types of donors will be discussed with you by one of the transplant coordinators. You will be notified in writing that you have been added to the list.

If you are determined to be “not appropriate” for kidney transplant, you will be notified in writing with the reason. Your transplant coordinator will send a letter notifying you, your dialysis center and your nephrologist when you have been listed.