Written by:
Arthi T
Pre-transplant evaluation for kidney
Once the need for a transplant is identified, patients undergo a comprehensive evaluation process that includes blood tests, CT and other scans, assessments of the heart, lungs, and other organs, as well as consultations with various specialists.
This evaluation aims to:
Confirm the diagnosis and identify the cause of kidney disease.
Assess the severity of the kidney disease, its impact on other organs like the liver and lungs, and establish the urgency for a transplant.
Screen for cancer.
Evaluate the condition of other organ systems, such as the heart, lungs, and liver, to ensure the patient can tolerate the major surgery.
Determine the complexity, technical feasibility, and risks associated with the surgery.
The evaluation typically takes about 7-10 days and is conducted on an outpatient basis.
This period can be quite hectic and stressful, so patients are advised to relax between tests and carefully follow all instructions to ensure accurate results. The transplant coordinator serves as the primary contact during this evaluation, scheduling appointments in consultation with the nephrologist for various tests and procedures.
The evaluation plan may change at each stage based on test results, so it is crucial for patients to routinely visit the hospital for reviews by the transplant team. Patients who are unwell might need to undergo evaluation in the hospital. If issues such as cardiac disease, thyroid problems, or infections are detected, they must be treated before proceeding with the transplant.
Patients with other health conditions, such as uncontrolled high blood pressure or untreated cardiac issues, may need to wait until these problems are resolved. Kidney transplants can still be performed after successful cardiac procedures like angioplasty or heart bypass surgery.
If a suitable family donor is not available, and the recipient’s evaluation is satisfactory, the patient is placed on the waiting list for a deceased donor kidney transplant.
Patients should arrange for blood products and finances well in advance of the surgery. It is important to address and understand all doubts during the preparation for a transplant. Patients and donors are encouraged to connect with others who have undergone the operation and are willing to share their experiences.
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Preparing for kidney transplant
Avoid blood thinners including aspirin for at least one week prior to surgery. The day before surgery, eat light meals until noon and then clear liquids. Stay well hydrated; the day of surgery, you should drink clear liquids until two hours before arrival at the hospital. Do not eat any solid food or complex liquids after mid-day before surgery. Make sure that you have a good bowel movement either the night before, or the morning of surgery. If you have difficulty with bowel movements start a clear liquid diet one day before surgery
Pre-transplant evaluation for liver
Once End Stage Liver Disease (ESLD) is diagnosed and a transplant becomes necessary, patients undergo a comprehensive evaluation process. This includes blood tests, CT scans, other imaging tests, assessments of the heart, lungs, and other organ systems, and consultations with various specialists.
The evaluation has several key objectives:
To confirm the diagnosis and identify the cause of cirrhosis or ESLD.
To assess the severity of the liver disease, its impact on other organs such as the kidneys and lungs, and determine the urgency of the transplant.
To screen for the presence of liver tumors.
To evaluate the condition of other organ systems, such as the heart, lungs, and kidneys, and assess the patient’s ability to undergo this major surgery.
To determine the complexity, technical feasibility, and risks associated with the surgery, considering factors like previous abdominal infections, surgeries, and liver blood vessel thrombosis.
This evaluation typically spans 7-10 days and is conducted on an outpatient basis. Given the potential for this period to be hectic and stressful, patients are advised to relax between tests and follow all instructions carefully to ensure accurate results. The pre-transplant coordinator will be the primary contact during this period, scheduling appointments for necessary tests and procedures. As the evaluation progresses, the plan for further tests may change based on patient reports, making routine visits to the pre-transplant clinic essential for reviews by the transplant team.
Patients who are severely ill may need to undergo evaluation while admitted to the hospital. If unexpected issues such as cardiac disease, thyroid disease, or infections are discovered, they must be treated before proceeding with the transplant. Additionally, patients with other conditions, such as uncontrolled high blood pressure, diabetes, or untreated cardiac problems, may need to wait until these issues are managed.
A liver transplant can still be performed after successful cardiac procedures like angioplasty or heart bypass surgery.
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Waiting list
A person who is a first-degree relative of the patient (as defined by the Transplantation of Human Organs Act) or has received special permission from the government-appointed authorization committee, can donate a kidney.
If a suitable donor is not available, the patient is placed on a waiting list to receive a kidney from a deceased donor. This is a combination of blood type and antibody matching, time spent with kidney failure, and a few other characteristics that give people priority on the list when it comes to kidneys. In general, waiting times can range from months to years.
Positioning on the waiting list
Your doctors use results of liver function tests and all the test results at the time of evaluation to determine your prognosis and your place on the liver transplant waiting list. Your prognosis is sometimes called your Model for End-Stage Liver Disease (MELD) score. The higher your MELD score, the more dire your situation. People with higher MELD scores generally are offered donated livers first. MELD scores range from 6 to 40.
Waiting for a new liver
Waiting for a donor liver could be in weeks or it could be months. As you wait for a new liver, the doctor will treat any complications of your liver failure, to make you as comfortable as possible. Complications of end-stage liver failure are serious, and you may be frequently hospitalized. If your liver deteriorates, your MELD score is updated.
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Preparing for liver transplant
Once the transplant decision has been confirmed by all the concerned parties, the next step is making an arrangement for blood and blood products. Around 18 units of blood (in most cases, from any blood group unless the patient falls under a rare blood group) will be required in advance from the patient’s family members. Similarly, 3 counts of platelet donations will also be needed but this time it should match the same blood group as the patient. Platelets are usually obtained a day before the surgery as they have a very short shelf-life. In case of any emergencies or difficulties, there are chances that additional blood might be required before surgery or have it replaced after surgery. In any case, the transplant team will keep the family in the loop of any changes or requirements on this front.
How Milaap can help
In situations where medical insurance or government schemes fall short for transplants, platforms like Milaap provide a vital lifeline. Milaap is a leading crowdfunding platform that helps individuals raise funds for medical treatments, including organ transplants. By connecting patients with compassionate donors, Milaap ensures that financial constraints do not stand in the way of life-saving medical procedures.
If you or your loved ones have exhausted all available financial resources, Milaap is here to help. The platform has a proven track record of impacting the lives of those in need by enabling them to access essential medical care without the burden of insurmountable costs.
Organ transplant success stories on Milaap
In times of need, support means everything, and with Milaap, you need not look any further. Milaap enables you to set up a fundraiser for any medical emergency within minutes, and you can easily raise funds for treatment expenses.
Do you know someone who could benefit from fundraising? Simply refer them to us and we’ll be happy to lend a hand.
Visit www.milaap.org or call us on +91 9916174848 to get started now.
For more information, write to us at cx@milaap.org.
