Before Kidney and/or Pancreas Transplant Surgery
UC San Diego Health System screens and evaluates your health and related circumstances to help determine the best treatment path when considering kidney and/or pancreas transplantation. Upon referral from your nephrologist, endocrinologist or other physician, an extensive course of testing may occur, such as:
- Blood and urine tests to help assess liver and kidney function, blood count, blood type, blood chemistries
- Ultrasound scan to further examine kidney function and locate any masses in the kidneys or pancreas
- Chest X-ray to determine the health of lungs
- CT Scan or MRI to create an image of abdominal structures and look for cancer
- Electrocardiogram to help identify irregularities in heart rhythm and the electrical activity of your heart.
- Echocardiogram to help evaluate how the heart is pumping, how blood flows in the heart and blood vessels, how large the heart is and how the valves are working
- Pulmonary function test to measure lung capacity
- Psychosocial evaluation by a social worker to determine what social support you have, who will help you before and after transplant, how well you cope with stress
- Psychological evaluation to determine your mental state of well being by performing certain neurocognitive tests.
- Nutrition Evaluation to assess your current nutritional state, determine any deficits, and help provide suggestions to optimize your needs and assist in losing weight if indicated.
- Financial/Insurance Review to review and coordinate your insurance, transplant benefits including copayments and planning for post transplant medication needs.
More or less tests may be required based on your medical condition. Following the testing, the kidney and pancreas transplant team will explain the benefits and drawbacks of transplantation to you and your family and discuss if you are eligible to be placed on the national registry for a donor kidney and/or pancreas.
Getting On The List and Having A Donor
Organ Transplant Waiting List
Following approval for transplantation, newly evaluated patients are added to the national United Network for Organ Sharing (UNOS) deceased kidney and/or pancreas waiting list.
UNOS oversees the allocation of deceased donor kidneys and pancreases. Blood type, length of time on the waiting lists, and organ size are all considered when matching organs and recipients. For a kidney transplant, a lymphocytotoxic crossmatch test is performed to assess the suitability of a potential donor and avoid rejection of the new kidney. Your surgeons will determine which organ is best suited for you to achieve the best long-term outcome. Read more about organ allocation and donation.
Read more about the UNOS waiting list and process for deceased donor organ transplantation at organdonor.gov.
Brothers Paul and Bill Coari have been sharing wilderness adventures every summer since Bill donated his kidney to his brother more than 10 years ago. But this summer’s journey was a bit more memorable-they hiked to Kidney Lake. Read their story.
Bill and Paul on Mount Langley a year after the transplant.
Living Donation for Kidney Transplantation
Every effort is made to find a living donor if you are in need of a kidney transplant. A living kidney donor eliminates the need to wait for a compatible deceased donor and results in improved long-term function of the transplanted kidney.
Today, nearly 50 percent of donor kidneys now come from living donors. Once the living donor has completed the workup and has been found to be suitable donor candidate a preoperative workup is performed. This includes the necessary imaging studies to identify whether the left or the right kidney will be removed
This is followed by a preoperative appointment and scheduling of surgery for both the donor and recipient. Our team of minimally invasive surgeons performs the donor operation robotically. This results in faster recovery time for the donor, smaller incisions and less scarring. The donor will typically be discharged from the hospital in one to two days, and come in for follow up appointments at one week, six weeks and one year.
Take the first step to becoming a living donor by completing a short, private health history questionnaire. Start the process.
Staying Well Before Surgery
It is critical to stay as healthy as possible before surgery so that that transplantation can be successful. Your transplant team, nephrologist and endocrinologist will work with you and support you in your daily effort to be in the best health possible before your transplant surgery. As an academic medical institution, UC San Diego Health System can offer programs, new technologies and research opportunities that may help you maintain your best health before the donor organ is available.
Getting the Call
Your transplant coordinator will notify you when a deceased donor kidney and/or pancreas become available. You could receive the phone call at any time of the day or night. We will help you put a plan in place for being able to respond rapidly and arrive at the hospital prepared. Once further tests and evaluations are finalized, the transplant team will complete standard pre-operative preparations and proceed with the transplantation.
Read more on care after surgery for kidney, pancreas or combined kidney-pancreas transplantation.