When potential recipients are referred they are given an appointment for a basic initial evaluation.
This evaluation includes:
- Interview with a transplant nurse coordinator
- Interview with a transplant social worker
- Medical evaluation by a transplant nephrologist
- Blood tests, chest x-ray, and EKG (a basic heart tracing)
The initial blood testing includes tests to identify a patient's blood type and antigens. This is how we identify if a donor is a match for the recipient.
Many patients require additional medical and psychological testing that may include, but is not limited to, evaluation by a transplant surgeon, urologic evaluation, cardiac evaluation, stress testing or possibly a cardiac catheterization, psychiatric evaluation, pulmonary testing or vascular evaluation of blood supply to legs and the brain.
Also, patients who may have problems with Hepatitis C are seen by a liver specialist in order for them to make an informed consent regarding their future care. Additional factors considered during the evaluation are the recipient's follow-up with evaluation appointments and adherence to medical plans of care. We often have to rely on the local dialysis treatment doctors and nurses for some of this information.
During the evaluation process we inquire about possible living donors. Once a recipient passes the initial testing, we may do blood testing on potential living donors. This is the first step for the donor evaluation and tells us only whether donors are blood type compatible and whether they share any antigens.
Living donors need to initiate this process with us by calling the transplant office. The information on how closely they match to the recipient is shared with the donor, who can then share it with the recipient, if they choose. We do not proceed any further with the donor evaluation until we have completely cleared the recipient as a transplant candidate. Donors must wish to undergo the evaluation.
The donor evaluation involves the following tests:
- Interview with a transplant nurse
- Interview with a transplant social worker
- Medical evaluation by a transplant nephrologist
- Full battery of lab tests
- Renal ultrasound
- Chest x-ray, EKG
- Urine studies to check for protein and creatinine
- Interview with the urologist who would perform the donor surgery
- Renal arteriogram and/or abdominal CT scan
Depending on the findings in the initial testing some of these tests may be repeated or others added to evaluate possible medical problems discovered. At any point in this process the potential donor may decide not to continue, or the medical staff may tell the donor that donation of a kidney would not be in their best medical interest.
Contact Information
Voice: 919-684-5859
Fax: 919-681-7930
Email: Kidney_Transplant@mc.duke.edu
