Before Kidney Transplant
The decision to perform a kidney transplant – as opposed to recommending ongoing dialysis treatment – depends on a variety of factors. These include patients’ overall health, the severity of their kidney condition, the availability of suitable donor kidneys, and patient preferences and treatment goals.
People with end-stage renal disease – the last stage of chronic kidney disease – can be referred to us by their nephrologist. We perform an evaluation, including tests to find compatible donors as well as an overall health assessment, to determine eligibility for the transplant. Patients can either come to our Dallas location for this evaluation, or to one of our convenient satellite transplant clinics in Lubbock or Tyler.
Time is critical to people waiting for kidney transplants. One of the strengths of our Kidney Transplant Program is that we spend an average nine weeks conducting comprehensive pre-transplantation evaluations on prospective transplant recipients and prospective kidney donors.
Those time frames are considerably shorter than the national averages, thanks largely to our statewide satellite locations. This network of clinics allows our kidney transplant specialists to see more patients faster, shortening the wait and expediting care.
Patient workups are critical in helping us determine if kidney transplantation is appropriate. As part of the evaluation, patients meet with our care team, which includes kidney specialists, surgeons, transplant coordinator, social worker, and financial counselor.
We complete a comprehensive health evaluation to determine if the patient should be placed on the transplant waitlist. Tests can include:
- Urine tests
- Compatibility tests: Blood typing, tissue typing, and crossmatching to match patients with a kidney
- Blood tests: To check heart, kidney, liver, thyroid, and immune system
- Pulmonary stress testing
- Computed tomography (CT) scan
- Body mass index (BMI) evaluation
Candidates for kidney transplant must have:
- Chronic irreversible renal failure requiring dialysis or nearing the need for dialysis
- Life expectancy of 3 or more years post-transplant
- Absence of any known or suspected conditions which are unlikely to improve with transplantation or which render transplantation futile
- A willingness and ability to accept kidney transplantation, comply with follow-up care, and cover the costs of transplant surgery and post-transplant care
This list is not comprehensive; please ask our team for more details.
If we believe that a kidney transplant is the best treatment option for a patient – and he or she wishes to pursue this option – the patient’s name is added to the national United Network for Organ Sharing (UNOS) waiting list.
Wait status priority is dictated by how long a patient has been on dialysis and the availability of suitable donor kidneys from cadaveric (deceased) donors. The average wait for a deceased donor kidney is four to six years, depending on blood type.
Living donors (nearly one in three of the kidneys we transplant come from living donors), allow for an expedited path towards achieving transplantation, and is an area our team has particular expertise in.
At UT Southwestern, there are multiple ways in which patients can receive donated kidneys.
Using kidneys from living donors, UT Southwestern Medical Center’s Living-Donor Kidney Transplant Program offers transplant patients better long-term outcomes and survival rates while ensuring that donors’ health and interests are protected.
Living kidney donation can be a beautiful, bonding experience. But not just anyone can donate a kidney. Stringent screening is required, and potential donors often have a lot of questions about their eligibility and how donation will affect their health in the future. Get more information on becoming a living donor.
In a deceased donor transplant, a kidney is transplanted from someone who has recently died and had given consent to be a donor.
In a paired exchange, an incompatible kidney donor and recipient pair are matched with another incompatible donor and recipient pair, and the donated kidneys are exchanged between the pairs.
“Of the about 20,000 kidney transplants that we do in this country about a third of them are from living donors, but at the end of the day, there’s still another 90,000 people waiting on the list for a kidney transplant.”