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American Family Children's Hospital

Kidney Transplant Referrals


If you are interested in having an evaluation to determine if you are a potential transplant recipient, you, your physician, or any other caregiver may contact the program.

Referring providers and patients who have questions about setting up an appointment for a potential kidney transplant should call (608) 263-9531. At any time you may ask to speak to one of the pre-transplant kidney coordinators or a transplant surgeon.
Referring providers or the patient themselves, will be asked to provide the following information about the patient when calling to make a referral: name, address, phone number, date of birth, social security number, cause of kidney failure, primary doctor, insurance, and if the patient has received a transplant previously.
After the initial referral call, the provider or the patient will be asked to forward the following patient records as they are available: 
  • Current history and physical
  • Current labs, including a creatinine clearance if the patient is not on dialysis, and a PSA for men >50 years old
  • Cardiac tests including, ECG, Echo, stress test, cath report/film, cardiac surgical report
  • Medication list
  • Overview of radiology reports
  • Overview of discharge summaries and clinic visits
  • Operative notes from major surgeries
  • Mammogram, pap and pelvic exam results for females
  • Documentation of any cancer diagnosis and the treatment
  • Colonoscopy report (if done within past three years)
  • Advance directive or living will
  • Chest X-ray report
  • Records from a previous transplant evaluation or transplant