From initial evaluations to surgical procedures and the necessary after care, transplant patients undergo the entire process at the George Washington University Hospital and GW Medical Faculty Associates.
Evaluation of Candidates
The GW Transplant Institute evaluates people who could be candidates for kidney transplantation. The evaluation starts with education about transplantation and the candidate signing a consent to be evaluated. A series of tests and consults will follow the education and consent process. Tests include:
- Blood type
- Liver and kidney function
- Past exposure to viruses, such as the HIV virus and hepatitis A, B and C
- Immune system evaluation
- Human Leukocyte Antigen (HLA) Typing: A blood test used to match you with a donor.
- Panel Reactive Antibody (PRA): A monthly blood test to see if you have antibodies that could cause you to reject kidneys from certain donors
- Lung evaluation
- Chest X-ray
- Heart evaluation
- EKG to assess your heart rhythm
- Echocardiogram to assess your heart function
- Cardiac stress test to check for coronary artery disease (CAD)
- Cardiac catheterization to find disease in the arteries of your heart (if needed)
Each candidate will also meet with the GW Transplant Team. Team members include:
- Transplant kidney doctor (nephrologist)
- Transplant surgeon
- Transplant coordinator
- Transplant social worker
- Financial coordinator
- Dietitian (if needed)
- Transplant pharmacist (if needed)
- Other specialists (if needed)
What Happens When I Finish My Testing?
After you meet with the team and your results are in, the GW Transplant Team will meet to review the findings. Here is what happens next:
- The team may request additional tests or consults.
- When the decision is made, we will notify you by phone and letter. You will be told of the decision to list you for a new kidney or that transplantation is not the best option for you.
- We cannot list you until all tests are complete. We can put you on the list more quickly if you complete your evaluation sooner.
What Does it Mean to Be Listed for a Kidney Transplant?
Patients are listed for a new kidney with the United Network for Organ Sharing (UNOS). All patients needing a new organ are listed with UNOS.
Kidneys are given to patients according to blood type and time spent on the transplant waiting list (which includes the length of time on dialysis).
Waiting Period
Your referring nephrologist and primary care physician will continue to manage your healthcare needs while you wait for your transplant. While on the waiting list, you will need to make periodic visits to the Transplant Institute so that doctors can assess changes in your health status, address concerns and provide support. Visits to the GW Transplant Institute do not substitute routine primary care physician visits.
Changes in your medical condition can influence the time to transplantation. It is important that the GW Transplant Institute knows about any significant changes in your medical condition or hospitalizations. Please have your referring nephrologist and primary care physician contact us with regular updates of your current health status.
Surgery
We will schedule your surgery in advance if you are undergoing a live donor transplant. The morning of the surgery, we will admit both you and the donor to the hospital.
The process is different if you are receiving a deceased donor transplant. When UNOS matches you with a deceased donor, the organization will contact the transplant surgeon and clinical transplant coordinator. The surgeon will determine if the organ is suitable based on an established medical criteria, organ condition, recipient condition, patient availability and organ transportation. The coordinator “on-call” will then contact your nephrologist. If the coordinator obtains medical clearance from your nephrologist, the coordinator will contact you.
The coordinator will give you special instructions you’ll need to follow to prepare for surgery and we will perform a final test to conclude your compatibility with the donor organ.
Kidney transplant surgery takes approximately three to four hours, not including time spent in the recovery room. Family members may wait in the surgery waiting area. After the surgery, the transplant surgeon will speak with your family about your condition.
Post-Transplant Care
After surgery, you will go to the post anesthesia care unit (PACU) or recovery room. From there, we will closely monitor you in the ICU until you are ready to complete your hospital stay in the surgical unit.
Your body will need help adjusting to your new kidney. Our transplant team will prescribe medications that will decrease the risk of rejection while closely monitoring your condition. Working together with your nephrologist and primary care physician, we will arrange effective follow-up checkups and tests.
UNOS Patient Services Line
The United Network of Organ Sharing (UNOS) provides a toll-free patient services line to help transplant candidates, recipients and family members understand organ allocation practices and transplantation data. You may also call this number to discuss any concerns or experiences you would like to share about your transplant center or transplantation system in general. The toll-free patient services line is 1-888-894-6361.