Introduction: It is important for patients and family members to understand the basics of kidney transplantation. An important question is “Which medical center should I go to for my kidney transplantation?
Only select medical centers can perform kidney transplantation. Medical centers have to obtain approval from the US government for performing kidney transplantation. Every year few centers start doing transplantation and occasionally some centers close their transplant program. All patients should carefully consider following points before selecting a medical center for kidney transplantation.
- Geography: It is preferable that patients select a transplant center closer to their residence. There are many advantages for selecting a center closer to home such as: easy access for transplant evaluation, follow-up at the center while on the wait list, quick travel to the transplant center when kidney is available for transplantation and convenient multiple post-transplant clinic visits. However, patients can select a center far away for other reasons such as special expertise, short wait time and if one is rejected at a center closer to their residence or if they have family members who can support them for follow-up at a far away center.
- Convenience: Convenience is the key for transplant patients and family members. After kidney transplant, patients may require multiple visits to the transplant center. Hence, it is preferable that patients select a center, which is convenient for the patient as well as for their family members or friends who may be assisting patients after transplantation.
- Insurance: All potential kidney transplant patients will require adequate insurance coverage. Patients may have private insurance or Medicare as their primary insurance. Most of the transplant centers will accept patients only if they have adequate insurance coverage. Many private insurance will direct their patients to select transplant centers. Essentially, some insurance will not cover if kidney transplant is done at a center. Hence, it is important to undergo transplantation at a center where there is appropriate insurance coverage.
- Short-wait time: Waiting time for kidney transplantation vary from one US state to another, one region to another and one part of the country to another. Patients have to investigate and find out which transplant centers have a shorter wait time for kidney transplantation. This information changes over time and is not easily available. Transplant Interface, LLC can provide this information through their website. Steve Jobs went to Memphis, TN; for transplantation and is perhaps because he had resources and he also found out that the wait time was shorter in Memphis at that time. Thus, if a patient has adequate resources, he or she should consider listing at a center which has a shorter wait time.
- Expertise and outcome: Patients preferably have to chose a transplant center based on transplant centers expertise and good outcome. Patients and family members cannot easily assess expertise. Expertise can be judged by the name brand of the transplant program, number of transplants that are being performed by the center each year, number of patient listed at the center and input from other patients and referring kidney doctor who has had personal connection and experience with the transplant center. Patients and family members should ask questions to the transplant center about their outcome. US government provides 1 and 3 year survival rates for all transplant programs regular. Patients should consider transplantation at a center, which has good or at least acceptable survival rates. These outcomes do change every 6 months.
Thus, patient should select a center for his or her transplantation based on Geography, Convenience, Insurance, Short-wait time for transplantation and Transplant center’s expertise and outcome.
Information on this topic is available through Transplant Interface, LLC http://transplantinterface.com