KIDNEY
Pre Transplant


Kidney transplants are performed as treatment for end-stage renal disease (ESRD), or kidney failure. Diabetes is the leading cause of kidney failure. Diabetes can damage blood vessels and nerves, thereby affecting kidney function. Uncontrolled high blood pressure can also lead to kidney failure. Other diseases for which transplantation may be indicated include glomerulonephritis, an inflammatory kidney condition, and polycystic kidney disease, a genetic disorder producing numerous cysts as well as other diseases negatively affecting kidney function.

Types of Transplants

Living donor: A living donor can be "related" (parent, son, daughter, brother, sister, aunt, uncle, niece, nephew, cousin) or "non-related" (husband, wife, in-laws, friends). A living donor is the ideal choice for several reasons:

  • There is a higher transplant success rate achieved due to better donor-recipient tissue matching.
  • The time spent waiting for a suitable kidney is significantly decreased.
  • The surgery can be scheduled at a convenient time for both the donor and the recipient.
  • Recipient receiving a live donor kidney may require fewer immunosuppressive medications.

Please refer to our Live Donor Program link on this Web page for more information.

Deceased donor: If a living donor is not available, a kidney from a deceased donor is considered for transplantation. In this case, the potential recipient is placed on the UNOS national donor waiting list. Because the donated kidney must match the recipient's blood type, the waiting period can be several years. While waiting, the recipient must follow the physician's orders and be evaluated periodically.

Pre-Transplant Expectations

The first step in the transplantation process begins with a referral to the Texas Transplant Institute by the prospective patient's physician. A transplant financial coordinator verifies insurance benefits and begins creating a financial plan regarding all transplant services. The clinic then contacts the patient and the referring physician's office to discuss expectations and schedule an appointment for a half-day pre-transplant evaluation. Recipients are encouraged to bring their potential donors with them to the initial visit.

During the initial clinic visit, the patient meets with the transplant team, including the transplant physician, nurse, dietitian, and social worker for a psychosocial evaluation. After the first visit, the transplant team meets to review and discuss the medical, psychosocial, and diagnostic test results from the evaluation at a Patient Care Conference to determine candidacy.

Usually within two weeks of the first visit, the patient, referring physician, and insurance company are given the recommendations made at the Patient Care Conference. For most patients, additional diagnostic tests are required. The clinic’s scheduling staff will work with the patient and dialysis center to have those tests completed as quickly as possible.

Once additional tests are completed and reviewed by the transplant surgeon, the patient is added to the UNOS national donor waiting list and candidacy is determined. If the patient has potential living donors, the donor evaluation begins only after the recipient is cleared. The process for clearing a transplant recipient might take a few weeks or could continue for months. The Texas Transplant Institute is committed to working with the patient at a comfortable pace throughout the evaluation process.

If a compatible living donor cannot be found, the patient must wait for a kidney from a deceased donor which may become available at any time of the day or night. While waiting, the patient follows the physician's orders for dialysis and routine evaluations. Once a kidney becomes available, the patient will be contacted and given specific instructions. The patient will undergo pre-operative testing and receive a physical examination by the transplant physicians to ensure their medical condition is still suitable to receive a new kidney.

Private insurance, as well as Medicare and Medicaid, provides coverage for kidney transplants. However, the costs may not be fully reimbursed. The Texas Transplant Institute coordinates benefits with social agencies and other potential funding sources to help finance transplants. Our financial coordinators can assist the patient with information and planning.

Our medical, social, and financial specialists are always available to answer questions and provide assistance regarding transplantation.