Evaluation

The evaluation process begins with a referral, then proceeds with visits by the transplant surgeon, nephrologist, social worker, transplant coordinator, and financial counselor.

The following procedures are routinely performed as part of the evaluation:

• Complete medical and surgical history - Determines what additional tests may need to be done.

• Physical exam(s) - Gives an overall picture of the patient's conditions.

• Tissue typing - This test is done on white blood cells. White blood cells have special "markers" that distinguish "tissue type", which are used to find a matching kidney.

• HLA - Human Leukocyte Antigens

• Panel Reactive Antibody (PRA) - A way of measuring immune system activity within the body. PRA is higher when more antibodies are being made. It is easier to acquire a kidney if a recipient's immune system is calm or measures 0%. An immune system may be active from blood transfusion, pregnancy, a previous transplant or a current infection.

• Blood tests - The patient's blood count, blood and tissue type, blood chemistries, and immune system function will all be checked. In addition, blood tests for certain infectious diseases will be performed.

• Chest x-ray - Determines the health of the patient's lungs and lower respiratory tract.

• Electrocardiogram (EKG or ECG) - Determines how well the patient's heart is working and may reveal heart damage that was previously unsuspected.

Other tests and imaging studies may include the following:

• Ultrasound with Doppler examination - Determines the quality of the iliac vessels.

• Pulmonary function test - The patient will be asked to breathe into a tube attached to a measuring device, which will reveal how well his lungs are working and determine his blood's capacity to carry oxygen.

• Upper gastrointestinal (GI) series - This will show whether the patient's esophagus and stomach are disease free.

• Lower GI series - Ensures that the patient is free of intestinal abnormalities.

• Renal function studies - Urine may be collected from the patient for 24 hours in order to determine if the kidneys are working correctly. Blood tests such as serum creatinine are also performed to measure kidney function.

• Viral testing - Determines if the patient has been exposed to hepatitis, cytomegalovirus (CMV), Epstein-Barr (EBV), or acquired immune deficiency syndrome.

• Mammogram - X-ray of a woman's breast that can detect signs of breast cancer.

• Pap smear - Cells collected from a woman's cervix that are microscopically analyzed for signs of cancer.

• Echocardiogram - Reveals any abnormalities in the heart.

• Dental Evaluations - Your dentist must tell us that your teeth and gums are healthy. You will also need to be checked by your dentist every year while you are waiting for your transplant.

• Other tests - Any special tests or doctor visits that might be needed for the transplant workup.

Most evaluations are in an outpatient setting, although some patients are admitted if their medical condition requires it.