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Kidney Transplant Frequently Asked Questions

Kidney transplant at University of Wisconsin Hospital and Clinics has a significantly higher transplant rate compared to other transplant centers nationally, according to www.ustransplant.org, the definitive source for transplant data.

 

Eligibility for Kidney Transplant

 

Is there an age limit?

 

Each patient is evaluated on a case-by-case basis, but it is uncommon to offer transplantation to patients who are older than 75 years of age.

 

Is there a weight restriction?

 

Each patient is evaluated on a case-by-case basis, but generally we require a body mass index (BMI) of 35 or less.

 

Do you transplant children?

 

Yes, we have a pediatric transplant program. 

 

I'm a Jehovah's Witness. Can I get a kidney transplant?

 

Yes. Jehovah's Witnesses do not accept blood transfusions for religious reasons. They believe organ donation and transplant is a matter of individual decision.

 

Jehovah's Witnesses are often assumed to be opposed to organ donation and transplant because of their belief against blood transfusion. However, this merely means that all blood must be removed from the organs and tissues before being transplanted. At the time of transplant evaluation and prior to surgery, the physician will discuss possible risks during surgery which might merit blood transfusion or use of blood products. For example, a high level of blood loss might cause providers to recommend blood transfusion. The patient may still receive a transplant if they are willing to accept the possible risks associated with refusing blood transfusion or blood products.

 

Transplant Evaluation

 

How do I set up a kidney transplant evaluation?

 

You can either call (608) 263-9531 for an appointment or have your primary care physician or nephrologist refer you to our center. You will be assigned to a pre-transplant coordinator who will guide you through the evaluation phase.

 

Is the surgeon I see during my evaluation the same one who will be doing my surgery?

 

Not necessarily. The transplant surgeons work as a team and a different surgeon may be working on the day you have your transplant.

 

Why do I have to talk to a social worker?

 

Consulting with a social worker is a critical part of the transplant evaluation process. Meeting with a social worker will help you prepare for the impact that a transplant may have on other aspects of your life, and to identify potential resources. Additionally, Medicare regulations require the transplant center to have a social worker assess each patient prior to placing a patient on the transplant wait list.

 

Why do I have to talk to a dietician?

 

A registered dietician specializing in the care of transplant patients assists with nutritional care prior to transplant to help with weight loss or maintenance, as well as guidelines for preserving kidney function. Post-transplant, patients often experience side effects of medications that benefit from nutritional interventions. Additionally, Medicare regulations require the transplant center to have a dietician assess each patient prior to waitlist placement.

 

Why do I have to come back for re-evaluation if I'm already on the list?

 

Your health status may change with time so it is important for you to have a re-evaluation. This helps to keep track of medical changes and to ensure that you are always ready for transplantation and do not miss an opportunity. The changes may affect your waitlist status.

 

Kidney Transplant Wait List

 

What number am I? Your position on the wait list changes based on many factors according to the kidney allocation system through UNOS (United Network for Organ Sharing). These factors include your blood type, your time on the wait list and the characteristics of the donor. Given the current system, it is not possible to give you an actual number. The allocation system is currently under review by UNOS. There may be changes to the system in the next few years.

 

How long will I wait?

 

The average waiting time varies according to different blood types and can range from six months to two years. Waiting time differs from transplant center to transplant center.

 

Why is the wait list different at other centers?

 

Each center maintains its own wait list for their patients. Because not all patients are listed at the same center, the lists are always different.

 

Why is the waitlist shorter at UW?

 

It may not be that the wait list is shorter, but the wait time is shorter at UW because more transplants are performed than at many other centers. Additionally UW Organ and Tissue Donation is one of the highest performing OPOs in the nation, which affects the supply of kidneys available for transplant.

 

Can I be listed on more than one wait list?

 

Yes, if you choose. Being on more than one wait list can potentially decrease the time you are waiting for a transplant because you could now draw on a larger pool of deceased donors. However, many transplant programs share the same Organ Procurement Organization (OPO). Therefore, for multiple listing to be beneficial, it would be important to be listed in transplant programs that are located in different OPO donor service areas.

 

How does the "on hold" process work?

 

There are times when your status might change from being “active” on the kidney waiting list to being "on hold". During the time when you're listed as on hold, you continue to accrue waiting time (seniority). However, you will not be available for a deceased-donor transplant. Your coordinator will let you know what is needed prior to reactivating you on the waiting list.

 

The reasons for being on hold vary, but might include health changes such as infection or hospitalizations. It may also include compliance issues or administrative issues such as your chart not being up-to-date. It may be a decision you make if you're going on vacation, not emotionally or physically ready for transplant or if you're waiting for a living donor.

 

Are there any medications or blood products I should try to avoid?

 

Yes. Kidney patients should try to avoid receiving any blood products (whole blood, plasma, platelets, red blood cells) because this can increase antibody levels in your blood. High levels of antibodies make it difficult to find a tissue matched donor. Transplant coordinators should be notified if a patient takes a blood thinner, such as Coumadin or Plavix, even on a temporary basis.

 

Prior to transplant, patients should consult their local nephrologist for guidance on medications. There are certain medications that can damage kidney function, such as non-steroidal anti-inflammatory drugs (NSAIDs). Some nephrologists may recommend avoiding these medications prior to starting dialysis, when patients are trying to preserve kidney function. After dialysis is initiated, this may be less of a concern. After receiving a kidney transplant, patients will receive guidance from the transplant team about medications.