Transplant Readiness

Transplant as a treatment option

A successful kidney transplant is considered the optimal treatment for most patients with ESRD offering better quality of life and longer survival than dialysis for many patients. It is not a cure for kidney disease, but it is a path to a significantly different life.

Not every patient is a transplant candidate. Age, other health conditions, and other factors affect eligibility. If you have not had a conversation with your nephrologist about whether transplant evaluation is appropriate for you, that conversation is worth initiating.

The transplant evaluation process

Before you can be listed for a transplant, you must go through a transplant evaluation a series of tests and appointments at a transplant center designed to determine whether you are medically and otherwise suitable for transplant. This process can take weeks to months.

Requesting a transplant evaluation referral from your nephrologist is something you can advocate for. If you have not been referred for evaluation and you believe transplant may be an option for you, ask directly whether a referral is appropriate and why or why not.

The deceased donor waitlist

Once you are approved for transplant, you are placed on the national deceased donor waitlist managed by UNOS (United Network for Organ Sharing). Time on dialysis before listing counts toward your wait time in many circumstances. This means the sooner you are listed, the better if transplant is appropriate for you.

Waiting times vary significantly by blood type, region, and other factors. In some areas, median wait times are several years. Being listed early matters.

Living donor transplant

Kidneys from living donors typically family members or close friends often have better long-term outcomes than deceased donor kidneys. If someone in your life has offered to be evaluated as a living donor, that conversation should happen through your transplant center, not just informally.

Living donor evaluation is done entirely at the expense of the transplant program donors do not pay for their evaluation. This is worth knowing if a potential donor has expressed concern about cost.

Staying active on the list

Being on the transplant list is not passive. You must keep your contact information current with the transplant center. You must be reachable at any hour when a kidney becomes available you typically have hours, not days, to respond. Your health must remain within acceptable parameters for transplant. And you must follow up with the transplant center as required.

Patients who stay engaged with their transplant center, attend required appointments, and proactively communicate changes in their health tend to navigate the process more successfully.