When patients come to Penn for a kidney transplant evaluation, the team performs an extensive evaluation of their kidney disease and general health to determine if transplant is a possible treatment option. The evaluation is usually completed in one day, although additional consultation or testing may be required.
Read the patient selection criteria for kidney transplantation.
Once the kidney transplant evaluation is scheduled, every patient receives a packet of information in the mail to help them prepare for the appointment. If the appointment was recently scheduled for a date in the near future, the documents can be downloaded, completed, and returned to the office where the appointment is taking place.
Review this form to determine your community network--the ones you can call on for help.
What To Expect
During the evaluation visit, patients and their families meet with members of the transplant team including a transplant nurse coordinator and receive detailed information about transplant preparation, health management during the waiting period, anti-rejection medications and an overview of the transplant process. Patients see a transplant nephrologist, a doctor who specializes in kidney diseases, and sometimes a transplant surgeon to discuss their medical history, receive a physical examination, and to describe the different types of kidneys that are available for transplantation.
Patients are encouraged to consider living kidney donor transplantation since it offers the best chance of success and survival.
In addition, patients will talk with a financial coordinator to ensure they have adequate insurance coverage for the procedure and medications. Other members of the kidney transplant team including the social worker and nutritionist may meet with patients and their families as well.
Tests and procedures performed during the evaluation include:
- Blood tests
- Tissue-typing tests, performed as part of the blood tests
- General lab screening for evidence of hepatitis or other viral disease
- PSA (prostate specific antigen) for men over the age of 50
- EKG (electrocardiogram) If not recently performed elsewhere
- Chest X-ray If not recently performed elsewhere
Depending on age and gender, additional tests may be required.
The kidney transplant team meets weekly to determine whether kidney transplant is the best treatment option for every patient evaluated. A member of the transplant team then contacts the patients with the results of this discussion. If the kidney transplant team decides that transplant is the best option and patients agree, patients are "listed for transplant."
Kidney Transplant for HIV Patients
The Penn Transplant Institute is a leader in providing kidney transplants for HIV patients. Patient and graft survival rates for HIV patients are similar to those of other high-risk populations. As part of the in-depth kidney transplant evaluation process, patients receive a consultation with a Penn Medicine infectious disease specialist. To initiate the evaluation process, patients HIV must be well controlled for at least three months. Patients should also be receiving HIV medications and have a CD4 count greater than 200.
Read the New England Journal of Medicine's report on kidney transplantation and HIV-infected individuals.