Kidney Transplant Evaluation Process 
 
 
 
 
 

 

 

 

 

The initial visit to the transplant center consists of meeting with the transplant surgeon, nephrologist, nurse coordinators, social workers and financial consultants.

Patients undergo an extensive medical evaluation which involves the following exams and tests: 

  • Physical exam
  • Chest x-ray
  • Complete medical and surgical history
  • Electrocardiogram (EKG or ECG). Shows how well the heart is functioning as well as any heart damage.
  • Echocardiogram.  Shows any abnormalities in the heart.
  • Ultrasound with Doppler examination.  Tests the quality of the iliac vessels which is essential to the success of kidney transplants.
  • Blood tests.  Includes testing for blood count, blood and tissue type, blood chemistries, immune system function and certain infectious diseases.
  • Blood typing.  Every person is a blood type A, B, AB or O.  The donor’s blood type does not have to be identical to the recipient’s, but it must be compatible.  Compatibility is determined by cross-match testing.
  • Pulmonary (lung) function test
  • Renal (kidney) function studies
  • Tissue typing.  Performed on white blood cells and used to find a matching kidney.
  • Panel Reactive Antibody (PRA).  Measures immune system activity within the body.  PRA is higher when more antibodies are being made.  When a recipient’s immune system measures 0%, a kidney can be acquired more easily.
  • Viral testing.  Determines if the patient has been exposed to hepatitis, cytomegalovirus, Epstein-Barr or acquired immune deficiency syndrome (AIDS).
  • Mammogram Pap smear.  Cells collected from a woman’s cervix are analyzed for any signs of cancer.
  • Dental evaluation.  Patients must have a dental exam before they are listed for transplant.  The dentist must confirm that the patient’s teeth and gums are healthy.  Follow up dental exams must be performed every year until the transplant takes place.
  • Other tests.  The Transplant Team may determine that additional tests are needed, depending on your medical condition. 

Many of the required medical tests may be performed locally, if desired, in collaboration with the patient’s primary care physician. Overall medical condition rather than age is the key factor in determining a patient’s suitability for transplantation.       

When a Kidney Becomes Available

When a donor kidney becomes available, the donor must be tested for compatibility with the recipient. Blood type determines the compatibility for kidney transplants. Kidney donors and recipients with compatible blood types are further tested for “tissue-type” compatibility with a test known as CROSS-MATCH.

Cross-Match Testing.  The recipient’s blood serum is mixed with the donor’s blood cells. If the recipient serum does not kill the donor cells, the test indicates that the donor and recipient are “compatible” and the transplant can be performed. A recipient may have to be tested with many potential donors before a match is found and some “tissue-type matches” may be better than others. Age, sex, or race of the donor and recipient are not determining factors in successful cross matching. Once the kidneys are removed from the donor, they are preserved until transplanted.

When a recipient is selected, the organ is sent to the recipient’s transplant center.     

Preparing for Surgery

Before surgery, the patient may receive an enema or a laxative to clean out the intestines and prevent constipation after surgery.  An intravenous line will be inserted in the arm or just under the collarbone to give medication and prevent dehydration.  The patient will also receive a sedative to help him or her relax before going to the operating room.

 

 
 
 
 
 

Hahnemann University Hospital | 230 N Broad St, Philadelphia, PA 19102