Who is eligible for kidney transplantation?

It is important for patients and family members to understand the basics of kidney transplantation. An important question is “Am I eligible to undergo Kidney Transplantation?”

All patients with irreversible kidney failure are eligible to undergo kidney transplantation. Following points to be considered:

  • Kidney Function: However, only patients with permanent irreversible renal failure, i.e. on dialysis treatment or those imminent permanent renal failure defined as those with less than or equal (< ) to 20% kidney function are eligible to undergo kidney transplantation.
  • Cause of kidney failure: Kidney failure from all causes is eligible to undergo kidney transplantation. However, certain rare conditions like oxalosis may require kidney with liver transplantation.
  • Immigration status: Kidney Transplantation is usually performed for all US Citizens and legal aliens. However, non-US Citizens can undergo living donor transplantation at a US center. Cadaver donor (deceased donor) transplantation can also be performed for non-US Citizens with some restrictions.
  • Patient age: Biological age is more important than chronological age. This means that older patients with good physical, functional and mental status are considered for kidney transplantation. In general patients above the age 72 are not considered for kidney transplantation. However, certain centers do perform for robust older patients (75 or even up to 80 years). Transplant centers do encourage living donor transplantation for older patients, as they have to wait for a longer period for cadaver organs and may not do well on long-term dialysis.
  • Medical Conditions: Transplant center will not consider kidney transplantation for patients with active infections or malignancy (other than skin) and those with significant heart, lung, liver, and brain conditions. In addition, combination of good cognitive function, physical capacity and functional capacity are required to undergo kidney transplantation.
  • Social Issues: Most of the transplant centers will not consider patients who are actively smoking and those using recreational drugs as well as those with significant active alcohol use at the time of kidney transplantation.
  • Insurance: Transplant centers will also mandate adequate insurance coverage for kidney transplantation. Most patients will require combination of Medicare and secondary insurance to cover all expenses.
  • Family support: Support from family and or friends are necessary immediately after transplantation.

Above points provides some form of guidelines to patients. However, ultimately it is the decision about transplanting an individual is based on individual transplant center centered on their institutional policy.

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