What are the causes of renal failure? How can donated kidneys be obtained? How do I determine if I am a candidate for a transplant? How can I be evaluated or listed for transplant? What is the workup process like? What happens if it is determined I am a transplant candidate? What are my responsibilities while waiting for transplant? What is the process when a kidney is found? What happens when I get to the hospital? What will my surgery be like? How long will I be in the hospital? Do I have to go back to the hospital after transplant? How much will my medications cost? When can I return to work or school? What medications will I be on after transplant? What is a healthy lifestyle after transplant?


Question:

What are the causes of renal failure?

Answer

Kidney failure may be caused by one or more of the following:

  • Diabetes
  • Hypertension
  • Chronic glomurulonephritis
  • Polycystic kidney disease
  • Lupus

Question:

How can donated kidneys be obtained?

Answer

A kidney transplant can be obtained two ways:

  • Deceased donation – Patients most commonly receive a kidney from someone who passed away and had previously agreed to give the gift of life by registering as an organ donor or had family members who agreed to donate the deceased’s organs.
  • Living renal donation – A relative, friend, or loved one may offer to donate a kidney to you. Learn more about our Living Kidney Donation Program. Download and complete our Kidney Transplant Referral Data Sheet

Question:

How do I determine if I am a candidate for a transplant?

Answer

Although there are many different factors as to why a patient is or is not eligible for a transplant, we currently do not transplant patients with the following occurrences: active malignancy, HIV positive, pregnancy.

Question:

How can I be evaluated or listed for transplant?

Answer

Patients can self-refer themselves for transplant evaluation by calling 832-355-4100. You will be asked a few questions including:

  • Demographics/insurance information
  • Dialysis information
  • Name and phone numbers of current doctors
  • Short medical history

You can also download and complete our Kidney Transplant Referral Data Sheet (pdf). All information on the application must be complete before the team can begin processing the referral. Your dialysis nurse or social worker may be able to assist you with completing the application.

Question:

What is the workup process like?

Answer

A standard set of tests including labs and x-rays give a clear picture of your overall health status. They also help to identify potential problems before they occur. We can determine whether or not transplantation is truly the best option for you. The tests during the evaluation include:

  • Blood tests - Assesses your overall physical condition.
  • Tissue typing - A special blood test that helps find a donor kidney that matches and provides valuable information about your body's immune system
  • Colonoscopy – Screens for colon cancer for anyone over age 50.
  • Chest X-ray  - Assesses the size of your heart and checks for lung abnormalities
  • Voiding cystourethrogram (VCUG) - Assesses the function of the lower urinary tract
  • Abdominal US - Examines the kidneys, liver and gallbladder for cysts, stones or other abnormalities
  • TB Skin testing – Tests for exposure to tuberculosis.
  • Gynecological exam – All women need a gynecological exam within the last year. Mammograms are also required for all women over age 40.
  • Pulmonary function studies – Persons with a history of lung disease or tobacco use will undergo pulmonary (lung) function studies.
  • Cardiac tests – Assesses your heart function via an echocardiogram and electrocardiogram (EKG or ECG). A stress test and a cardiac catheterization are done if needed.
  • Physical examination – Assesses your overall condition

Because everyone is different, every evaluation is tailored to evaluate each person’s specific needs.
Medical Review Board: When your evaluation is complete, your case is presented to the Medical Review Board (MRB). The MRB consists of nephrologists, transplant surgeons, transplant coordinators, a dietician, social workers, and a financial counselor. The MRB will weigh the risks and benefits of dialysis vs. transplantation to determine which method is best for you. You will be notified of the MRB’s recommendation by one of the transplant coordinators.

Question

What happens if it is determined I am a transplant candidate?

Answer

If you are accepted for transplantation, you will be placed on a national computer list of active candidates waiting for a donor. Recipients are chosen according to a complex set of criteria, including blood type, body and organ size, physical condition, age, and length of time on the waiting list. The United Network for Organ Sharing (UNOS) coordinates the equitable sharing of organs throughout the United States and oversees all donor centers and procurement agencies.

The waiting period can range from several months to several years. Many factors are considered when matching donor kidneys to recipients. Some of the factors that affect wait time are body size, age, and antibody level.

Below are approximate wait times for our area based on the recipient’s blood type: O blood type – 2.5 years A blood type – 1.5-2 years B blood type – 2 years AB blood type – 1.5 years

The transplant coordinators must be able to contact you 24 hours a day and you must be able to get to the hospital within a reasonable amount of time once a kidney becomes available. When a donor kidney is found, you will be notified immediately and given instructions.

Question:

What are my responsibilities while waiting for transplant?

Answer

While on the transplant list, you must maintain active medical insurance. Failure to do so may impact your ability to receive a kidney.
You must notify the transplant center if there are any changes in:

  • Insurance
  • Dialysis unit
  • Address or phone number
  • Medical condition
  • Infections
  • Surgeries/hospitalization
  • Blood transfusions

Question:

What is the process when a kidney is found?

Answer

When a potential donor is identified, the coordinator will call (it is very important to keep us aware of any change in address, phone number, or dialysis unit) with specific instructions, and give you a timeline for your care and transplant.
When you are instructed to come to the hospital the coordinator will give you a time and place to report, and will let you know when to stop eating and drinking.
When you come for surgery, please bring:

  • Current medication list
  • Drug allergies list
  • Current health insurance information (current insurance cards)

Question:

What happens when I get to the hospital?

Answer

After admission, you will have a thorough physical examination, including blood work, chest x-ray, and EKG. Unfortunately, in some cases the surgery must be postponed and you will be sent home. The reason for canceling the surgery might be for one or more of the following reasons:

  • Infection
  • Additional medical problems
  • The donor kidney shows signs of poor function
  • A problem is identified with match between the donor and recipient

If the surgery is canceled, you will remain on the transplant list.

Question:

What will my surgery be like?

Answer

  • The surgery normally takes 3-4 hours
  • The incision will be in the lower abdomen/pelvis area and is usually 6-10 inches long

Question:

How long will I be in the hospital?

Answer

  • After your transplant, you are typically in the hospital 4 to 6 days. Follow-up appointments are in the Transplant Clinic.
  • If you live out of the Houston area, you are typically required to stay near St. Luke’s for one month post transplant so we can monitor your kidney function and drug levels closely.

Question:

Do I have to go back to the hospital after transplant?

Answer

(Clinics and labwork) – You will have to follow up with your nursing and nephrology staff after your transplant to make sure your new kidney remains healthy. Clinic schedules vary according to the nephrologist managing your care. Typically, patients are seen every week for the first month post transplant, and then reduce in frequency over time. You will need to have lab work done before each clinic visit. Any additional testing to monitor your health and kidney function will vary from patient to patient. Tests may include renal scans, ultrasounds, and kidney biopsies. Typically, patients are seen by the nephrologist at St. Luke’s for one year after their transplant, and then are transitioned back to the nephrologist’s private office.

Question:

How much will my medications cost?

Answer

Medication expenses vary according to your health insurance and any supplemental funding. If you need more assistance, please see the “Financial Considerations” tab.

Question

When can I return to work or school?

Answer

You may return to work or school about 4 to 6 weeks after transplant, depending on your kidney function and your response to medication. Most patients are able to return to a healthy level of normality at this time.

Question:

What medications will I be on after transplant?

Answer

Post transplant, you will be on several different medications.

  • Immunosuppression medications – These medications keep your body from fighting off your new organ. They may include: Neoral, Prograf, Cellcept, Myfortic, Rapamune, and Prednisone
  • You may be on other medications to control blood pressure, glucose, manage cholesterol, antibiotics and antivirals, diuretics, iron supplements, and vitamins. You may also go back on any pre-transplant medications to manage any other pre-existing conditions.

Question:

What is a healthy lifestyle after transplant?

Answer

There are several factors that will help you keep your new kidney healthy. It is important to maintain a healthy lifestyle after transplant. You will need to exercise regularly, maintain a healthy diet, and keep a weight that is healthy for your body frame. You will need to take your medications regularly and report any problems or side effects to the transplant team. You will also need to come to your scheduled clinic visits. You can help your transplant team monitor your care by keeping records of your blood pressure, blood sugar, weight, temperature and pulse.

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