The evaluation stage includes a complete physical exam and tests that assess your kidney, liver, heart and lung functions. These tests, along with comprehensive blood work, help determine if you are a transplant candidate. Tests and procedures likely to be completed as part of your transplant evaluation include:
- Chest X-ray
- EKG (Electrocardiogram)
- CT or MRI scan
- Cardiac stress test
- Colonoscopy, if older than 50
- Pap smear, all females
- Mammogram, all females
- Additional tests may be added depending on your medical history and physical exam
During evaluation, you will also meet with our physician, surgeon, nurse coordinator, social worker, financial case manager and dietitian to discuss all aspects of transplantation.
Our multidisciplinary Organ Transplant Selection Committee meets to decide if you are eligible for transplantation. Once deemed a transplant candidate, you will be placed on the UNOS national waiting list by your blood type. At this time, we may also begin discussing Living donor transplantation as a treatment option.
Organ Transplant Waiting List
Once the transplant team has decided that transplantation is a treatment option for you, you will wait for a compatible donor organ to become available. You will be added to the national waiting list or wait for a live donor to be evaluated.
The United Network for Organ Sharing (UNOS) is a national organization that regulates how organs are allocated. An organ procurement organization, or OPO, works with UNOS to identify organ donors and allocate them to transplant centers, based on a national scoring system.
For kidney transplantation, many factors determine who will receive an organ offer. For kidney transplantation, many factors determine who will receive an organ offer. When matching donor kidneys to recipients, many things are taken into consideration, including blood type, tissue type, age and medical history. When matching donor kidneys to recipients, many things are taken into consideration, including time on dialysis, blood antibodies, EPTS score and previous transplants.
For liver transplantation, recipients are placed on the national waiting list by blood type and Model End Stage Liver Disease (MELD) score. This score is based on lab values, including INR, bilirubin and creatinine. Individuals with higher MELD scores, which indicate disease severity, are higher on the waiting list.
Time on the waiting list is not predictable. Some patients may wait longer for a compatible organ than others. People are added to and removed from the waiting list frequently. You may also choose to be listed at multiple transplant centers.
Receiving the Call
You will receive a call from one of our transplant nurse coordinators when a compatible organ is available. The nurse will ask you about your current health and how you are feeling at the time of the call. We will need to know if you are taking new medications, have any fever, vomiting, diarrhea or any infections. In some instances, we may not be able to perform a transplant if you are too sick. You should always notify the transplant team if you have changes in your health. Occasionally, we may call you for transplant, but cancel, perhaps due to organ quality. We do not want to perform a transplant unless both the donor organ and the recipient are in good health and ready for great outcomes. In most cases, the nurse will give you specific instructions over the phone letting you know when to come to the hospital, where to check in, and what to bring with you for transplantation.
Once you have arrived and been placed in a room, we will begin some pre-operative testing such as an EKG or chest X-ray and additional blood work. We will begin to prepare you for surgery. You will meet with members of the transplant team who will go over the procedure and gather important consents for treatment.
The Transplant Surgery and Post Operative Care
Once the organ has arrived and you are ready for surgery, you will be taken to the operating room. Organ transplantation is a surgical procedure that will require general anesthesia. After you enter the operating room, the anesthesia doctors will put you to sleep and place a breathing tube, as well as a special type of IV in your large neck or groin veins, that allow us to give you your medication. The nursing staff will place a catheter into your bladder.
In some instances, you may have a short stay in the Intensive Care Unit (ICU) and then transition to the transplant floor where we will create a discharge plan. As you recuperate in our new transplant facility, our patient and family centered care environment will provide the perfect setting for comfort and healing. You can even visit our new therapeutic healing garden during your stay.
After you are discharged from the hospital, you will have routine visits to our Transplant Outpatient Clinic. We will monitor you closely with lab work and office visits. Our goal is to ensure your new organ is working well, your transplant medications are effective and that you are healing well from your surgery. It is important that you are also aware of your body after your transplant. You will need to notify our team if you are experiencing any side effects from your medications, having issues taking your medications, or showing any fever or signs of infection, including nausea or vomiting, diarrhea, swelling or pain.