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Related Experiment Videos

Kidney transplant candidate evaluation.

John D Scandling1

  • 1Department of Medicine, Stanford University School of Medicine, and Stanford Hospital and Clinics, Palo Alto, California, USA. jscand@stanford.edu

Seminars in Dialysis
|January 10, 2006
PubMed
Summary

Practicing nephrologists are vital for kidney transplant candidates, ensuring timely evaluation for preemptive or expedited transplantation. Continuous communication with transplant centers is crucial for successful wait-list management and successful kidney transplants.

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Area of Science:

  • Nephrology
  • Transplantation Medicine
  • Immunology

Background:

  • The practicing nephrologist plays a critical role throughout the kidney transplant process, from initial referral to post-transplant care.
  • Early referral can facilitate preemptive kidney transplantation, a goal achieved in 25% of living donor cases.
  • Kidney allocation policies increasingly favor zero human leukocyte antigen (HLA) mismatch and expanded criteria donor kidneys, potentially leading to faster transplantation.

Purpose of the Study:

  • To emphasize the indispensable role of practicing nephrologists in evaluating kidney transplant candidates.
  • To highlight the necessity of prompt and thorough evaluation for successful early transplantation under current allocation systems.
  • To underscore the importance of ongoing communication between nephrologists and transplant centers for effective wait-list management.

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Main Methods:

  • Review of current kidney transplantation practices and allocation policies.
  • Analysis of the nephrologist's involvement in candidate evaluation and preparation.
  • Discussion of challenges in wait-list management and the need for active communication.

Main Results:

  • Preemptive transplantation is achievable in a significant portion of living donor cases.
  • Approximately 30% of deceased donor kidneys are transplanted under specialized allocation policies.
  • Prompt nephrologist evaluation is essential for candidates potentially receiving rapid offers.

Conclusions:

  • Practicing nephrologists are essential for successful kidney transplantation, particularly with evolving allocation strategies.
  • Continuous nephrologist engagement and communication with transplant centers are vital for managing growing wait-lists and optimizing patient outcomes.
  • Thorough and periodic re-evaluation by nephrologists ensures candidates remain prepared for transplantation, even after long waits.