Kidney – Recipient Selection Criteria
- Age Limit
- Adult – chronological age of 18 to 70 years (>70 will be considered on a case by case basis taking into consideration physiological age)
- Medical
- Approaching End Stage Renal Disease (ESRD) or documented ESRD according to UNOS criteria for ESRD. Pre-dialysis referral and evaluation for live donor kidney transplantation will be encouraged
- Satisfactory nutritional status
- Morbid obesity (BMI > 40) is a relative contraindication
- It will be at the surgeons' discretion how much weight will be lost for this group
- No malignancies, unless adequately treated with appropriate disease free interval documented
- Absence of co morbidity that would pose prohibitive operative or immunosuppressive risk. Advanced cardiopulmonary disease that is progressive and irreversible is a contraindication.
- No active infection (can resume evaluation once infection is controlled)
- No active systemic autoimmune disease (reviewed on a case by case basis)
- Psychosocial
- Family and patient (as appropriate) accept responsibilities of transplant procedure and compliance with health regime before and after transplant
- Patient takes active role in care and/or has a strong family support system
- Appropriate motivation for transplantation
- No psychiatric problems which would preclude compliance with transplant care
- No active use of illicit drugs or alcohol abuse
- Tobacco use
- Patients must not use tobacco products. If assistance is needed to stop smoking, the patient will be referred to clinical psychologist and/or nephrologist for interview and direction to smoking cessation program/ plan. These patients may be monitored for compliance as indicated.
- All other patients will be encouraged to stop tobacco use and will be offered assistance if needed
- Repeated non-compliance to prescribed medical regime and/or substance abuse is a contraindication to transplantation
- Financial
- Patient and/or family will undergo financial counseling to establish transplant benefits including but not limited to Medicare, Medicaid, or private insurance prior to the start of the transplant evaluation.
- Financial status, with particular consideration given to change in insurance policies, will be tracked and re-evaluated on each clinic visit. The patient is expected to report any changes to the financial coordinator.
- Established hospital policies will be followed which allow for the provision of care in cases of unfunded patients