Transplantation

Transplantation places one healthy kidney into your abdomen. This one kidney is sufficient to replace the work of your two failed kidneys.

A kidney transplant can be the first form of treatment you receive or it can be selected later after receiving dialysis treatments for some time. Transplantation is the preferred treatment for certain people.

You may receive a transplant from a living related donor, a donor who is not related but willing to donate a kidney, or you may receive a kidney from someone who has recently died (deceased donor).

There is a regional matching service that is funded by the federal government. It updates the list of those waiting for a kidney, does the blood typing and tissue matching for the possible deceased donor transplant.

If a living donor is willing to give you a healthy kidney, this donor must be evaluated for medical fitness and compatible blood type. Depending on the type of donor, waiting time for a kidney will vary. The wait for a deceased donor kidney will be longer than that for a living donor due to the shortage of deceased donor kidneys. The surgery will take from 2 to 4 hours and your stay in the hospital will be 5-7 days.

Your doctor will prescribe several new medications to prevent rejection by your body of your new kidney. You will have to take these medications as long as the transplanted kidney works. Transplantation can offer you the greatest potential to return to a healthy and productive life.

Get more information on kidney transplantation from the United Network for Organ Sharing (UNOS). The information is also available in español.

Transplant Resources

Transplant Center Information

The United Network for Organ Sharing (UNOS) maintains a computer database of patients waiting for donated organs for transplant and records transplants performed in the United States. Data are collected by the Organ Procurement and Transplantation Network (OPTN) from hospitals and organ procurement organizations (OPOs) across the country. Find and compare transplant programs from the Scientific Registry of Transplant Recipients (SRTR)

Transplant Referral Guide

Facility-Specific Referral Criteria

Section 494.80(a)(10) of the revised Conditions for Coverage for ESRD Facilities, effective October 14, 2008, sets forth requirements for patient assessment with regard to transplantation referral:
"Evaluation of suitability for a transplantation referral, based on criteria developed by the prospective transplantation center and its surgeon(s). If the patient is not suitable for transplantation referral, the basis for nonreferral must be documented in the patient’s medical record."

Interpretive Guidance states that regulations for transplant programs require written selection criteria to be developed, and provided upon request, to patients and dialysis facilities. Selection criteria vary among transplant centers; if the dialysis facility refers patients to multiple transplant centers, the dialysis facility should have the selection criteria for each center on file and available to patients.

Transplant Referral Guidance (For All Patients in a Maintenance Dialysis Program)

Evaluate & Classify the Patient

The Medical Record Will Indicate That:

  • The patient has been evaluated of suitability for a transplant referral, based on individual transplant center criteria, by the interdisciplinary care team including, but not limited to, a nephrologist, a nurse, a social worker, a dietitian and the patient or patient designee

  • The patient has been classified as a suitable or unsuitable candidate for transplantation.

  • This initial assessment must be completed within 30 calendar days of admission to the facility or within the first 13 outpatient treatments within the facility.

  • The ESRD Conditions for Coverage mandate a comprehensive reassessment of each patient annually (at minimum) with the revision of the Plan of Care. Both the patient assessment and Plan of Care should include reevaluation of treatment modality and transplant status.

Inform Patient & Document Decision

The Medical Record Will Indicate That:

  • Suitable patients were presented the option of referral to a transplant center for evaluation, received transplant center contact information, and received information on deceased donor and living donor transplant.

Document Transplant Status

If the patient IS a transplant referral candidate, the medical record will indicate:

  • Patient's decision to accept of decline the transplant referral

  • Plans for pursuing transplantation, if the patient accepts the referral

  • Patient refused the transplant option after further consideration

If the patient is NOT a referral candidate, the medical record will indicate:

  • Reasons for the non-referral as a transplant candidate

Track Transplant Referrals

  • Monitor the status of each patient on the transplant wait list

  • Communicate with the transplant center regarding patient status at least yearly and whenever there is a change in status

Medicare and Medicaid Programs; Conditions for Coverage for End-Stage Renal Disease Facilities; Final Rule. Federal Register 73:73 (15 April 2008) p. 20479.