The evaluation for a kidney, pancreas or kidney-pancreas transplant includes a number of tests, procedures and visits with doctors. It also includes meeting with many members of the
transplant team. The evaluation helps us determine if:
- Transplant is the right treatment for you.
- You are well enough to have transplant surgery.
- There is any other treatment besides a transplant that can help you
After your initial transplant clinic visit, the transplant team will determine which additional doctors you should see and what medical tests should be performed as part of your evaluation process. We need to make sure that you do not have infections, blood vessel problems or a cancer that would make transplant dangerous for you.
It can be a complicated process, so we’ve summarized it below and also created a visual guide, called Your Kidney/Pancreas Transplant Guide (PDF) to help illustrate the steps you need to take.
Evaluation and Testing
Some or all of the following tests may be included in your evaluation process. Other tests may need to be done based on the results of these tests or the medical evaluation performed by your physicians:
- A variety of
blood tests may be performed, which could include determining your current level of kidney function, your blood and HLA type for organ matching and a screening for exposure to infection, including HIV.
chest X-ray helps your doctor identify any problems with your lungs.
urine test (when possible) is done to screen for urinary tract diseases, as well as drugs and alcohol in your system.
EKG, echocardiogram and/or
stress test shows how well your heart is beating and the function of your heart valves. This helps your doctor decide if your heart function is strong enough for transplant surgery, or if additional cardiac testing and treatment is needed.
Pulmonary function tests (breathing tests) may be required, especially if you have a history of smoking, asthma or lung disease.
Pap smear, mammogram, and/or prostate-specific antigen (PSA) blood test and colonoscopy are general health and cancer screening tests that are done based on your age, gender and family history.
Imaging of your abdomen and a liver biopsy are done if you have hepatitis B or C
After the evaluation is complete, your case will be presented to the UWMC Kidney/Pancreas Transplant Selection Committee who will decide if you are a candidate for a transplant. You must be medically able to undergo the transplant procedure and be expected to survive for a reasonable length of time after the transplant. You must also show that you have the social, financial and support resources to be able to follow the complex medical care plan required for transplant patients.
The committee will decide:
- To accept you for placement on the kidney transplant waiting list.
- Not to accept you for placement on the waiting list and explain why you were not accepted.
- To schedule more visits and tests before they make a decision
You will receive a letter about the committee’s decision within 10 business days of your presentation to the committee.
Transplant Impact/Overall Care Plan and Options
Kidney transplants are life-saving therapies. However, the potential benefits also depend on your ability and commitment to follow the complex treatment plan prescribed by your doctors. The type of donor and the potential risks associated with the behavior of the donor are other factors that are considered. Your surgeon will explain this in detail to you and will assist you in choosing the best option for you.
Living Kidney Donor (LKD) Transplantation
The best treatment option for transplant candidates is a living donation of a kidney (a healthy relative or friend donates one of their kidneys). With a living donor, we can proceed with the transplant much sooner and the kidney lasts longer. Your doctors will talk with you about this option, but please click here for more information about LKD see our
Living Kidney Donor site.
Deceased Donor Transplantation and the Transplant Operation
When a deceased donor organ becomes available, you will be called and you must come to the hospital right away. If the organ comes from an extended criteria donor, or is a donation after cardiac death, your surgeon will assist you in making your decision. At this point, your surgeon has a clear picture of the risks associated with this particular organ versus the risk of waiting for the next available donor. You have the option to decline an organ. If the organ is determined to be unusable once we see it or the cross match is positive, you will be discharged to go home, but you will remain on the waiting list.
If the organ is a good match, you will receive general anesthesia, and will be in the operating room for approximately four hours.
Care and Recovery After Surgery
After the surgery, you will be taken to the Transplant Unit. The length of your stay in the hospital will depend on your rate of recovery, the type of transplant you have, the severity of your illness prior to transplant and/or any complications after surgery. If your new kidney is functioning, you will go home without dialysis. If it is slow to function, you will go home on dialysis. Your physicians will periodically evaluate your kidney function and determine when it is safe to stop dialysis.
After you leave the hospital, you will still be recovering. For the first four to six weeks, your doctor may recommend limiting your daily activities. If you have any complications after surgery, your recovery time may be longer. The transplant team will see you several times during the three to six months after transplantation. Your follow-up visits will include exams, lab tests, and scans of your abdomen to see how well your transplanted kidney is working. Biopsies may be done on a routine basis and as needed to diagnose possible complications, including rejection, infection or recurrent kidney disease.
No matter your condition, you will need to have lab testing done every one to two months for the rest of your life. This helps to identify problems early so that treatment may be started and be more effective.