Kidney transplant, a life-saving procedure, involves surgically replacing a diseased or non-functioning kidney with a healthy one from a living or deceased donor. It's the preferred treatment for end-stage renal disease (ESRD). Critical aspects include donor compatibility, immunosuppressive medications to prevent rejection, and lifelong post-transplant care to ensure kidney function and overall well-being. Successful kidney transplants significantly improve patients' quality of life, but they require meticulous evaluation, surgery, and ongoing medical management.

1. Kidney
Transplantation
Presented by Alshifa Healthcare services

2. Agenda
• Review treatment options for End-Stage Renal
Disease (ESRD)
• Review of kidney transplant options
• Overview of the evaluation process
• Care partner support
• Review of the listing process
• The surgery
• Post-transplant
• Transplant outcomes

3. Treatment Choices for ESRD
• Medical Management
• Hemodialysis
• Peritoneal dialysis
• Deceased donor kidney transplant
• Living donor kidney transplant

4. Benefits of Kidney
Transplantation
• Improved life expectancy
• Decrease cardiovascular
events (stroke, heart
attack, etc)
• Improve Quality of Life
• Less expensive than
dialysis

5. Quality of Life Considerations:
Dialysis/Transplant
Dialysis: Transplant:
• Fatigue • The number of medications you
take may increase or decrease
• Dietary/Fluid
Restriction • Pain/Recovery from surgery
• Fatigue typically improves
• Usually fewer dietary limitations
• Cramping
• Nausea
(eating healthy is important though)
• Freedom
• Infections
• Most report improved quality of life
• Time Investment
• Infections
• Pain

6. Demand >> Supply: Critical Organ
Shortage
Roughly 100,000 patients
waiting for a kidney
transplant
National Statistics:
• >3000 patients added
to wait list each
National average
waiting time is more
than 5 years for a
deceased donor
kidney!
month
• ~13 people die per
day while awaiting a
kidney transplant

7. Who should be considered for
a kidney transplant?
• All patients with ESRD (transplant discussion mandated by CMS)
• Patients with advanced Chronic Kidney Disease
• Ideally should be evaluated early (well before starting dialysis). GFR
must be <20 ml/min on at least one occasion to be actively listed
(although patients can be seen before that)
• The best outcomes occur when transplant is done before starting
dialysis (pre-emptive) or with minimal dialysis time
• No fixed age restrictions
• Transplantation is not a cure, but a treatment option for eligible candidates

8. Contraindications to
transplant?
• Absolute Exclusion Criteria
• Active Malignancy
• Active uncontrolled infection
• Unstable psychiatric or psychosocial
condition (i.e. substance abuse, non
compliance, inadequate social support,
history of considerable non-
compliance)
• Limited life expectancy
• Untreatable or advanced cardiovascular
or pulmonary disease (CHF, CAD, CVA,
PAD)

9. 9
Recipients of a Kidney Transplant Have a Longer Life
Expectancy Than Patients Who Remain on Dialysis
Expected remaining lifetime for recipients of a kidney transplant compared
with patients on dialysis (across sexes and various races)a
Based on estimates from 2012, recipients of a kidney transplant
had about 2.5 times more remaining years of life than patients on dialysis
a Data are from the United States Renal Data System (USRDS) 2014 Annual Data Report; estimates are from 2012.
USRDS. 2014 ADR chapters. http://www.usrds.org/2014/view/default.aspx. Accessed February 11, 2016.

10. The Kidney Transplant Team
Care Partner
Transplant
Referring
Physicians
Nephrologists
& Nurse
Practitioners
Transplant
Surgeons
Clinic Staff
YOU
Financial
Transplant
Coordinators
and staff
Coordinator
& Pharmacy
Counselor
Social
Workers &
Psychologists
Pharmacist
& Dietitians

11. Steps in the Evaluation Process
STEP 1
STEP 3
STEP 2
- Orientation (Today!)
- Testing - Review by the
transplant committee
- Specialized testing
- Referrals to specialist
- Care partner secured and
understands the role
- Have potential living
donors do online form/or
call the office
- Exam and interview by
transplant team

12. Blood Test
Referral to
Specialist
if needed
Radiology
Testing
Diagnostic
Testing
Physical
Exam
Heart
Testing
Age
Appropriate
Cancer
Screening Lung
Testing
• Colonoscopy
• Mammo/Pap
• PSA blood test

13. Cost of a Transplant
Travel

14. Financial / Pharmacy Questions
• You are assigned a financial counselor and pharmacy financial
counselor
• Your pharmacy financial counselor will assist with prescription
coverage post transplant and the benefit of using our Specialty
Pharmacy at Nebraska Medicine that is dedicated to our
transplant patients
• You will meet with them as part of your evaluation to discuss
insurance coverage
• Ask questions:
- What will my out-of-pocket costs be?
- Do I need a supplemental insurance policy?
- Do I have travel and lodging benefits?
- How much will my medications cost?
• You must inform the transplant team of insurance changes

15. Types of Transplants
Living Donor Deceased Donor
Wait time is 2 to 4 months Wait time is 1 to 3 years
Have a lower rate of
delayed graft function
May have an increased rate
of delayed graft function

16. Thanks
Alshifa Healthcare Services