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Transplant Recipient Information

Before your transplant: Evaluation and the wait list

Please note that the information provided here about the health evaluation is the process for adults. If you’re a parent of a child waiting for a kidney transplant, some of these steps may be different. After reading this information, it’s important to talk with your child’s transplant team to find out what is different.

Before you (the recipient) are considered for a kidney transplant, you’ll have a full health evaluation (workup). This means you’ll have tests done to make sure that a kidney transplant is a good treatment option for you.

Having a kidney transplant​ isn’t right for everyone. A transplant may not be right for you at this point if you have health problems or need other treatments before you can have a transplant. Sometimes health problems you didn’t know about are discovered during your evaluation.

For example, if you’re waiting for heart surgery, a kidney transplant may not be the treatment for you right now. But when you’ve had this surgery and your heart health is good, you can then start your evaluation to see if kidney transplant is now a good option. Or a person with a history of cancer might wait for a time after cancer treatment, and then have the evaluation for kidney transplant.

Health problems that may prevent or delay a kidney transplant are:

  • cancer that might spread
  • serious blood vessel or heart disease
  • serious lung or liver disease
  • serious urinary tract problems
  • bleeding problems
  • infections
  • obesity (high body mass index, 35 to 40)
  • not following your treatment plan - like not taking medicines as directed and missing appointments or dialysis
  • actively using recreational drugs or too much alcohol

Evaluation steps

There are 3 steps in your kidney transplant evaluation.

The first 2 steps usually require 3 months or longer to complete. How long it takes depends on:

  • your health and medical condition
  • the time it takes to get all the appointments and tests done
  • the time it takes to see specialists

Even though it takes a long time, all 3 steps are very important.

Step 1​​

To start your journey to see if a kidney transplant is right for you, you’ll:

  • get a referral from your nephrologist
  • attend an initial transplant information session either in-person or online

The presenters for the information session and this website work together to help you find out what you need to know about kidney transplants.

Step 2

This step includes the basis of your health evaluation, and these may lead to other tests or reviews. You’ll have:

  • medical tests
  • a heart evaluation
  • a dental checkup
  • cancer screening
  • an immunization review

Medical tests may include ultrasound, chest x-ray​, an electrocardiogram (ECG), an echocardiogram and blood tests for infectious diseases and viruses. If you have risk factors for heart disease, such as diabetes, you may have a cardiac stress test and other heart tests.

The cancer screening may include tests such as a Pap test​, FIT test (fecal immunochemical test), mammogram, and prostate test​.

Your immunization status will be reviewed and updated. All age-appropriate live vaccines must be administered before your transplant unless there’s a medical reason for you not to have a particular vaccine.

Step 3

In this step of your evaluation process, you’ll have an appointment with the:

  • transplant nephrologist or nurse practitioner
  • transplant surgeon

The transplant nephrologist or a nurse practitioner may order more tests or make appointments for you with other specialists. When all these tests are done and the results are back, they’ll check to see if a kidney transplant is right for you at this time. If a transplant may be a good option for you then an appointment will be made for you to see the transplant surgeon for a final evaluation.

Before you are put on the list for a transplant, your transplant team will give you more information about what to expect and what happens next. You can also come back to this website and review the information here as often as you need to.

When the evaluation is done, and your records show that you are eligible for a transplant, here’s what will happen:

  • if you have an approved living donor, you’ll be scheduled for kidney transplant surgery
  • if you don’t have an approved living donor, you’ll be put on the deceased donor wait list​

Transplant waiting list​

What affects wait times?

Once your transplant evaluation is complete, and if you don’t have a living donor, you’ll be put on the transplant wait list. How long you wait can depend on:

  • if you’re an adult or child – children usually get priority
  • your blood type – certain blood types have longer wait times than others
  • if you have an antibody against a potential donor (called sensitization) – can be due to a previous blood transfusion, previous transplant or pregnancy
  • if you need more than 1 organ transplant for example, you need both a pancreas and a kidney
  • your listing date – this is your dialysis start date, not the date you joined the transplant wait list
  • when and if a donor kidney becomes available

In general, people who have been waiting the longest are considered first within their blood group and priority group.

How long is the wait list?

There are many more people who need kidneys than there are donor kidneys available. The waiting list keeps getting longer, while the number of deceased donors has stayed the same over time.

The wait for a kidney transplant depends on a number of factors and may take several years if you don’t have a living donor. Learn more about living kidney donation​​.

While you wait

What you can do

Once you’re on the transplant waiting list, it’s important for the transplant program to know where you are and how to get in touch with you. You may also be asked to go to another information session to help get ready for your transplant.

Be available

You are always on call. You may get a call at any time if a match is found. The transplant team only has a short time to reach you, so make sure that all your contact information is up to date. A mobile (cell) phone may be the best option for getting in touch with you anywhere, any time, it’s a good idea to give a landline number as well, in case you’re in an area with limited or poor cell service.

If you know that you’ll be away and not able to accept a transplant, you must let the transplant program know.

If a match is found, a transplant doctor will call you. They’ll ask you questions about how you’re feeling and if you’ve had any changes to your health such as a blood transfusion or if you have or have had an infection.

Take care of your health

It’s extremely important to go to all your appointments with your healthcare providers, including:

  • regular follow-up appointments
  • screening tests for cancers such as colorectal, breast, prostate, and cervical
  • dental check-ups
  • blood tests
  • immunizations – keep these up to date

Some tests will need to be done each year to make sure that you’re still healthy enough to have a transplant. Follow the treatment plan that you and your kidney care team have agreed to. If you don’t follow the treatment plan, you may not be able to stay on the transplant waiting list.

Stay healthy

Everything you do to take care of your health and well-being while you wait will help your recovery and long-term health after your transplant. It can be hard to stay hopeful when there are changes to your health or when you can’t do your regular activities.

It’s important to keep following your treatment plan and make healthy choices, such as:

  • increasing your activity level
  • eating healthy food
  • quitting smoking
  • limiting how much alcohol and cannabis you use

If you want more information about programs and support for healthy living, talk to the transplant coordinators or your kidney care team.

For more information on the transplant wait list, watch the Welcome to the transplant wait list video.

What your transplant team will do

While you wait for a transplant, your main contact will be the transplant coordinator. They’ll call you to see how you’re doing, review your file, update your chart, order tests, schedule appointments, and keep your kidney care team up to date. If there’s a match waiting for you, a doctor from the transplant team will call you.

You’ll have appointments with the transplant nephrologist (kidney doctor on the transplant team) at least once every 2 years or more often if your health condition changes. They’ll make sure you’re medically well enough to have a transplant.

You may also see the transplant surgeon again to make sure you’re still a candidate for the transplant surgery. The surgeon will assess if there are changes to the inside of your abdomen (belly) and how well your blood is moving through your body and your blood vessels (called circulation).

Any medical problems you have may keep you from getting a kidney until your health gets better. Your listing date does not change when you are well enough to have a transplant.

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