Before we list you as a transplant candidate, you’ll need to go through our evaluation process. This is to help us determine: 1, the severity of your condition; 2, that you are healthy enough to undergo surgery; 3, that you can be compliant with our transplant guidelines; and 4, that you have a support system to help you with recovery.
Cardiopulmonary Tests
These are a set of tests that pertain to your heart and your lungs.
Also known as electrocardiogram. Our technician will attach pads on your chest to measure your heart’s electrical output over time. This will let us know if you have an abnormal heart condition, such as an irregular heartbeat or damage to the heart.
You’ll need to go through this test if you’re over 50 years of age, or diabetic. It’s like a CAT scan of your heart, but we’ll take one image while your heart is at rest and a second one while you are undergoing exercise, usually running on a treadmill.
We’ll ask you to breathe normally into a tube, and then we’ll ask you to inhale and exhale deeply. This will tell us your lung capacity and overall health of your respiratory system.
Will let us see if your lungs and windpipe are healthy enough to withstand the stresses of transplant surgery, since anesthesia can be very taxing to your respiratory system. The x-ray will also let us know if you have tuberculosis, or other lung problems.
Imaging Tests
This section consists of several scans that we'll conduct to analyze the internal structure of your body in a noninvasive way.
We’ll scan your abdomen, which will produce computerized images that allow us to look at the size, shape, and position of your kidneys and other organs. Our surgeons will also be able to determine where it would be best to attach the new kidney. A head CT scan will also be necessary if you suffer from polycystic disease.
An ultrasound lets us see the internal structures of your organs through the reflection of sound waves. This will allow our doctors see if you have cysts, or tumors on your kidneys. It will also allow our surgeons to learn how to navigate around your body before transplantation.
These are a series of ultrasound-type tests to view the speed and direction of blood flow within the blood vessels in your legs and neck. The new kidney will be connected to your lower abdominal blood vessels, so it’s important that there are no blockages or narrowing within them.
Blood Tests
We can learn volumes about your physical condition through your blood. These tests are just a few that you'll have to undergo to help us understand the state of your health.
Any infection will need to be treated before you’re approved as a transplant recipient. The lab will draw blood to test for hepatitis, cytomegalovirus, Epstein-barr, and AIDS. We may also check for tuberculosis this way, in addition to the chest X-rays.
The technician will draw blood to determine the ratio of red blood cells, white blood cells, and platelets in your bloodstream. Abnormally high or low counts of one of these three cell types will alert us that there's something wrong with your general health.
This is a blood screening of 14 different tests, which can diagnose a broad range of liver, kidney, and fluid functions. It can also tell us if you’re diabetic, or suffer from hypertension.
This test will require a stool sample to determine if there is hidden blood in your feces. A positive result may indicate colorectal cancer, or gastrointestinal bleeding, and will need further evaluation.
Compatibility Tests
These are blood tests that help us understand which type of donor you're most compatible with. The higher the compatibility levels, the higher the chance of success of the transplant. If you have a living donor who is incompatible, we offer a Kidney Paired Donation Program.
This is the typical A, B, AB, O blood test to determine which blood-type you are, and which types of donor kidney you can receive.
Our immune system works by destroying foreign bodies, and ignoring ones it recognizes. This recognition system occurs through six different proteins named ‘antigens’ that work like a lock and key mechanism. The more antigens that match between the donor and the recipient, the less likely the recipient is to reject the new kidney (a six-antigen match is ideal, but uncommon). If the antigen match is poor, the recipient will need to take more anti-rejection medications.
We’ll mix your blood with the donor’s and observe; if the donor’s cells coexist with your own, the two are compatible. If they attack each other, then they are not a match, and the donation may not proceed because the kidney is very likely to be rejected.
Panel Reactive Antibody tests (PRA) are a measure of the activity level of your immune system. The higher the activity levels, the more likely your immune system is to reject the transplanted kidney. When these levels get high, we’ll need to treat you with medications to bring them back down.
Other Evaluations
A general physical will be necessary to determine your overall health, weight, blood pressure, etc. Your body-mass index (BMI) needs to be below 35 at the time of transplant.
You’ll need to bring, or have your physician submit your immunization record. This needs to include hepatitis, tuberculosis, tetanus, and other standard immunizations.
Our physician will ask you a series of questions that helps us learn about past activities and habits that may put you at risk (it may also be submitted by a referring physician). For example, you’ll need to tell us about past alcohol, cigarette, or drug use, past hospitalizations, diseases, etc.
Also called an “endoscopy”, a small camera will be lowered down your throat into your stomach to look for abnormalities and diseases in your upper digestive tract. The same will be done from the colon to look at your intestinal walls, which is known as a colonoscopy.
Conditional Exams
You will need to undergo some of these exams, based on your age, gender, and medical condition.
The PSA test is a blood test that checks for Prostate-Specific Antigen, a protein that’s produced by your prostate. If its levels are above normal, it may mean that you have an enlarged prostate or prostate cancer.
For patients not on dialysis: We’ll ask you to collect and refrigerate your urine over a 24-hour period so we may track your urine volume and amount of protein in it; large amounts of protein could be a sign of kidney damage, possibly from hypertension or diabetes.
Certain candidates will be required to visit the dentist for transplant clearance. They will check for mouth infections or necessary dental work. If infections are found, they'll need to be treated prior to being added to the organ waitlist. If dental work is required, it should also be treated prior to surgery, since the chance of infection will increase after the transplant, due to anti-rejection medications.
