The Evaluation Process
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).
As soon as you are listed, we will need to be able to reach you if a new kidney is offered to you. When a kidney is available for you, the transplant nurse coordinator must make contact with you within onehour. If not, the kidney will be offered to the next person on the list.
Please give the team phone numbers of family or friends who can help us locate you. You need to have a plan for getting to the GW Transplant Institute for surgery. It is important to inform the Institute if and when your health status or contact information changes. Let us know if you move, change your phone number or change your insurance.
Can I Be Listed for a New Kidney at Other Hospitals As Well As GW?
You may be listed at more than one transplant center. However, your second listing should not be within the same organ procurement organization (OPO).
In the Washington, D.C. area, our OPO is the Washington Regional Transplant Community. It includes these transplant programs:
- George Washington University Hospital
- Inova Fairfax Hospital
- Medstar Georgetown Hospital
- Walter Reed National Military Medical Center
- Children’s National Health System
There is no benefit for you to be on two lists in the same OPO. You would be competing with yourself for a new kidney. It would be better to be listed in another OPO region, such as one in Baltimore or Richmond, Virginia.
How Long Will I Have to Wait for a New Kidney?
According to UNOS, the average waiting time in the Washington, D.C. area for a deceased donor kidney is three to five years. As you wait, you will be followed by your dialysis center or private doctors. The GW Transplant Team will meet with you once a year and may perform more tests as part of your required annual check-up for transplantation.
You will need to send blood specimens to Johns Hopkins Immunogenetics laboratory:
- The lab will send you test tubes for blood to take to your dialysis center or your doctor. Your dialysis center or doctor will draw the blood and send it to the lab.
- Blood may be needed every month to check for antibodies against potential donors.
Possible Complications After Transplantation
What are possible complications after transplantation?
Rejection and Infection
When the first transplants were done in the 1950s and 1960s, rejection was a big threat to transplanted organs. Until 1983, there was very little medication to help lower the risk of rejection. The drugs used today are stronger and better manage rejection risk. Since the medications that we give you to lower your chance of rejection suppress your immune system, it is harder for your immune system to fight viruses and bacteria. Your transplant team will work with you to find the balance between rejection and infection.
Types of Rejection
Even with medication, you may still reject a new kidney. The most common types of rejection are acute and chronic rejection.
Acute rejection usually occurs in the first few weeks after transplantation. If it is caught early, it can often be reversed.
Chronic rejection usually occurs months or years after transplantation. The kidney slowly stops working, and the recipient returns to dialysis and needs another kidney transplantation.
Infection is more serious for you as a transplant recipient than for the general population because your immune system in suppressed. Your body cannot fight a virus or bacteria because of the medications you take to lower your risk of rejection. The greatest risk of infection will be in the first few months when you are on a higher dose of these medications. When your dose is lowered, your risk of infection will be lowered too. Look for these common symptoms of infection and report them right away:
- Fever higher than 100° F (38°C)
- “Flu-like” symptoms
- Cough or shortness of breath
- Sore throat
- Pain or burning when urinating or feeling that you need to urinate frequently
- Drainage from a wound
- A wound that is red, warm to the touch and that is not healing