Pre transplant Evaluation
The purpose of the comprehensive evaluation is to determine whether the patient would be a suitable candidate for transplantation and to provide detailed information about the transplantation process to the patient.
Please be prepared to spend most of the day at our clinic. The patient will be evaluated by a transplant evaluation coordinator, transplant social worker, transplant nephrologist, and a transplant surgeon. Candidates are encouraged to bring family members or friends to the meeting. The transplant team discusses with the candidate and his/her family various aspects of transplantation, including:
- Cadaver and living donor transplantation
- Transplant kidney and transplant pancreas survival rates
- The evaluation process
- Donor and recipient compatibility testing
- Living donor evaluation
- Registration on the national and regional cadaver organ waiting lists
- The current waiting time for cadaver organ transplantation
- Anticipated hospital course
- Surgical procedures
- Potential complications
- Post-transplant medications and side effects
Determination of Candidacy
After this initial evaluation, transplant candidates are presented at the weekly Transplant Evaluation Committee meeting.
The committee members include our staff who participated in the initial evaluation, as well as other transplant surgeons, nephrologists and social workers.
A decision regarding candidacy is made by the committee and is communicated to the patient and the referring nephrologist.
Preparation for Transplantation
Once candidacy is approved, the candidate is placed on the cadaver organ waiting list or arrangements are made for any potential living donors to be evaluated.
After being placed on the waiting list, the candidate begins to accrue waiting time. However, a candidate cannot receive a kidney transplant before the completion of all tests and consultations recommended by the committee. As the waiting time to transplantation can be several years, candidates may be asked to undergo periodic testing to remain "active" on the waiting list. All evaluated patients continue to be cared for by their referring physicians. The transplant physicians are available for consultation and become actively involved if necessary. Patients who have traveled a long way to Stanford for evaluation may return home to await transplantation. For patients and family members returning to remote locations, assistance is provided in securing transportation back to Stanford when an organ is available. During the waiting period, the Evaluation Coordinator is available for questions from both patients and referring physicians. The histocompatibility lab requests regular blood samples for the testing of antibody levels. Dialysis units are requested to provide monthly medical updates on the health of the candidates. It is important for the transplant candidate to communicate with the transplant team about any serious changes in health. Keeping us updated and well-informed optimizes the likelihood of timely transplantation.