Kidney Transplant Evaluation

During your kidney transplant evaluation, we look carefully at your medical and personal circumstances, and we compare them to established guidelines. The guidelines help us identify risks and concerns, but they also leave room for our doctors’ judgment, based on their knowledge and experience.

Some of the Factors We Consider
Even if you think some items on this list might rule you out, don’t assume you’re not a candidate. Instead, contact us to request an evaluation. Our transplant experts will consider your unique situation and let you know whether a transplant might be safe and beneficial for you.

Here are some of the things we look for in kidney transplant candidates:

• Kidney failure stage: eGFR at or below 20mL/min/1.73m2
• We do not have an age cutoff, but candidacy at any age is determined by overall health, fitness, and the risks and benefits of transplantation.
• Consistent and reliable caregivers who can provide transportation and help you get essential medications
• Ability to get to Duke University Hospital quickly after we notify you of an available kidney
• Resources to support your post-transplant care, including medication, travel, lodging, and medical device expenses

If you have HIV, we also look for:

• CD4 count consistently greater than 200
• Clinical approval by a Duke infectious disease doctor

You may not be a candidate for a kidney transplant if one or more of these conditions apply:

• A history of cancer of the type or stage that could affect your survival or that of the donated kidney.
• Body mass index (BMI) above 45.
• Liver disease unless you have approval from Duke liver specialists.
• Active alcohol or other substance abuse.
• Issues with urinary bladder self-catheterization. This is necessary if your urinary drainage is poor.
• A history of not following medical recommendations, including not taking medications or not receiving dialysis treatment as directed. A marker of this might be if your phosphorous is consistently above goal.
• Any heart condition that would make transplant surgery unsafe or compromise your survival after transplant.
• History of stroke or transient ischemic attack within the past six months.
• Severe restrictive or obstructive pulmonary disease.
• Systemic infection.
• Non-healing ulcers or wounds.
• An untreated or uncontrolled psychiatric disorder that could affect your ability to care for yourself.
• Frailty or condition that would make surgery, your recovery, or your ability to bounce back from transplant complications especially risky.

Notification
Once you’ve completed your evaluation and all needed tests and screenings, your transplant coordinator will present your case to our selection committee. We’ll notify you of the committee’s decision.