Pre-transplant Evaluation
The kidney transplantation process begins when a patient, physician or dialysis unit staff member calls the UCSD Kidney Transplantation Program to schedule a transplant evaluation. Potential kidney recipients are evaluated by a transplant surgeon, who discusses all aspects of transplantation and immunosuppression with the patient and family. The patient’s acceptability for transplantation is usually determined after this visit, sometimes with the input of the entire transplant team.
After each step in the evaluation process, the referring physician and/or insurance provider is contacted to discuss the results of the evaluation and the decision concerning transplantation. Throughout the process, the transplant team encourages the patient, referring physician and insurance company to ask any questions that may arise during the assessment period.
The Donation Process
Following approval for transplantation, every effort is made to find a living donor for the patient. A living kidney donor eliminates the need to wait for a compatible cadaver donor and results in improved long-term function of the transplanted kidney. In most cases, newly evaluated patients are also immediately added to the national United Network for Organ Sharing (UNOS) cadaver kidney waiting list.
When cadaver organs are donated, the procuring organization contacts UNOS. Information about the donor is entered into the database and a computerized donor/recipient match is run for each donated organ. The resulting list of potential recipients is ranked according to objective medical criteria such as blood and tissue type, size of the organ, medical urgency of the patient, time already spent on the waiting list and distance between donor and recipient.
Using the match of potential recipients, the local organ procurement coordinator contacts the transplant center of the highest ranked patient and offers the organ. Once the organ is accepted for a patient, transportation arrangements are made and the transplant surgery is scheduled.
Every patient waiting for an organ transplant in the U.S. is registered in the UNOS computerized data network. All have equal access to donated organs. Waiting times can vary from months to several years due to matching difficulties.
Preparing for a Transplant
The patient or patient’s family is notified when a donor organ becomes available. The patient is told when to come to the hospital and should not eat or drink anything after midnight or once learning a kidney is available. The patient should bring the following items to the hospital:
Once further tests and evaluations are finalized, the transplant team completes standard pre-operative preparations and proceeds with the transplant.