If you have been diagnosed with end-stage kidney disease and need dialysis, you can request a transplant evaluation. Alternatively, ask your nephrologist to refer you for a kidney transplant evaluation.

To complete the referral process, you will need to provide us with a variety of information:

• Your current medical history and physical report
• Your most recent lab work
• Any radiology reports
• Any pathology reports, including a kidney biopsy, if available
• Reports of any surgery or procedures you have had (colonoscopy, pap smear, mammogram, abdominal surgery, etc.)
• Immunization records
• Documentation of any psychiatric history
• Reports of any dental work you may have had

Once we receive this information, a transplant nephrologist will review it thoroughly. Suppose we determine that you are an appropriate candidate for a transplant. In that case, we will schedule an appointment for you at our clinic. 

Scheduling your transplant
Before you undergo a transplant, we evaluate whether you're an appropriate candidate. Your first clinic visit will begin in the morning with a short orientation and proceed throughout the day. In this first visit, you will be seen by many of the professionals on our transplant team, including a transplant nephrologist, transplant surgeon, social worker, financial coordinator, transplant pharmacist, and dietician.

After your first clinic visit, our transplant team will clearly understand how to proceed with your transplant workup.

A majority of our patients will need additional testing to determine their suitability for transplant surgery. Some tests can be done during your initial visit; others can be done at your local hospital.

Testing & Evaluation
Next, we'll need to perform several pre-transplant tests that will help us determine your overall health status and identify potential problems before they occur. These tests also help us determine if transplantation is your best option.

Joining the waiting list
After completing your testing, your case is presented in a multidisciplinary selection meeting. Your options are discussed by surgeons, nephrologists, nurses, financial coordinators, social workers, and nutritionists. From here, a majority of patients are placed on the waiting list for a cadaveric pancreas donation.

When it is time for surgery
When a donor pancreas becomes available, the coordinator will call you to get ready. Since this call could come at any time during the day or night, the transplant team should be able to reach you whether you are at home, at school, at work, or on vacation.

Please provide our transplant team with the phone numbers of family members and close friends. Do everything you can to make sure you can be contacted immediately.

When the Phone Call Comes
When that phone call comes, everything will seem like a blur. The coordinator will advise you when to be present at the transplant center. You must move quickly and get to the transplant center without delay. When a pancreas becomes available, there is a time limit!

At the Hospital
After admission, you will have a thorough physical examination, including more blood work, a chest x-ray, an EKG, dialysis, and possibly other tests. Unfortunately, surgery must be postponed in some cases. You will be sent home if:
You have an infection or have developed any other medical problem that would interfere with surgery or recovery
The donor pancreas shows signs of deterioration or poor function
If surgery is postponed, the transplant team can help you through the disappointment. This is only a temporary setback, and the search for a new pancreas will continue.

During your transplant surgery
Before entering the operating room, your anesthesiologist will review your medical history. Once they have completed this review, they will give you some medicine to help you relax. You will then be taken into the operating room. Once you're asleep, special I.V.s will be placed to help monitor your status during the surgery. This process takes between 30 and 60 minutes. 

After everything has been properly prepared, your surgeon will begin your surgery. The surgery usually lasts between 2 and 3 hours. The surgery is generally performed through an incision close to your hip bone, measuring between 6 and 12 inches in length, depending on your size and the size of the kidney.

You should be ready to leave the hospital and head home within a few days after surgery. You will receive a schedule of follow-up clinic visits for lab tests and checkups. At these visits, your doctors will track your progress and detect potential complications as early as possible.

You should bring your medication list and surgery handbook to all follow-up visits. You will be given specific instructions for routine lab work or special tests that you might need.

Taking Care of Your New Kidney
The most important aspects of post-transplant care are listening to your doctors and taking your immuno-suppression medications, which you’ll need to take for the rest of your life. This medication greatly decreases the chance of rejection episodes, in which your immune system attacks the new kidney.

Modern medical advances — including immunosuppressant drugs that prevent rejection of the new kidney — make kidney transplant complications less common. Patient and organ survival rates are high, and life expectancy rates are reasonable. Intermountain's Transplant Center team is knowledgeable and experienced. Our expertise, paired with your diligent efforts to care for your new kidney, increases your likelihood of returning to everyday life.

Signs of Infection and Rejection
The primary concerns for your new kidney involve infection and rejection. Your local physician can handle many problems, such as colds or flu, adjustment of your medications, and minor diseases. Learn to watch for signs of illness and rejection that necessitate notifying a local physician or transplant team immediately:
Fever that continues for more than two days
Shortness of breath
Cough that produces a yellowish or greenish substance
Dry cough that continues for more than one week
Prolonged nausea, vomiting, or diarrhea
Inability to take prescribed medication Rash or other skin changes
Vaginal discharge or itching
Burning discomfort with urination
Exposure to mumps, measles, chicken pox, or shingles
Unusual weakness or light-headedness
Emergency-room treatment or hospitalization
Pain, redness, tenderness, or swelling at the incision siteFluid retention/weight gain (2 lbs. in 24 hours)
Decrease in urine output
Pain or burning during urination
Blood in the urine
A strong odor to the urine
Feeling an urgent need to urinate or need to urinate frequently

Team Utah - Idaho
Once you're well enough, we invite you to join Team Utah Idaho in the Transplant Games of America. The team comprises transplant recipients and living donors of all organs from throughout Utah and Idaho. Team members have ranged in age from 3 to 70. Grateful athletes with new hearts, kidneys, livers, lungs, and pancreas participate in strenuous athletic events to celebrate a new life and prove that organ donation brings a total return to good health.

Complete medical and surgical history: Determines additional tests that may need to be done.
Physical exam: Gives the doctor an overall picture of your condition(s).
Chest x-ray: Determines the health of your lungs and lower respiratory tract.
Electrocardiogram (EKG or E.C.G.): Determines how well your heart works and may reveal previously unsuspected heart damage.
Ultrasound with Doppler examination: Determines the quality of the iliac vessels.
Blood tests: Your blood count, blood and tissue type, blood chemistry, and immune system function will all be checked. Blood tests for certain infectious diseases will also be performed.
Pulmonary function test: You will breathe into a tube attached to a measuring device, revealing how well your lungs work and determining your blood's capacity to carry oxygen.
Upper gastrointestinal (G.I.) series: This will show whether or not your esophagus and stomach are disease-free.
Lower G.I. series: Ensures that you are free of intestinal abnormalities.
Renal function studies: Urine may be collected from you for 24 hours to determine if the kidneys are working correctly. Blood tests such as serum creatinine are also performed to measure kidney function.
Mammogram: X-ray of a woman's breast that can detect signs of breast cancer.
Pap smear: Cells collected from a woman's cervix are microscopically analyzed for signs of cancer.
Echocardiogram: Reveals any abnormalities in the heart.
Dental Evaluations: You need a dental checkup before being listed for transplant. Your dentist must tell us that your teeth and gums are healthy. You will also need to be checked by your dentist every year while you are waiting for your transplant.
Other tests: Any special tests or doctor visits that might be needed for the transplant workup.

Histocompatibility Laboratory Tests

Tissue Typing: This test is done on white blood cells. The white blood cells have unique "markers" that tell your "tissue type." You inherit tissue type from your mother and father. This test matches a kidney or pancreas.
Panel Reactive Antibody (P.R.A.): This test shows how active your immune system is. Getting a kidney is easier if your immune system is calm or measures 0%. Blood will be drawn at your dialysis center and sent to our laboratory. Your immune system may be active from blood transfusions, pregnancy, a previous transplant, or a current infection.
Crossmatch Testing: This test is done when a donor's kidney is available. Your blood is mixed with the donor's blood. If there is no reaction (negative crossmatch), then you are "compatible" with the donor. If there is a reaction (positive crossmatch), then the kidney will not work for you because it is "incompatible."
Other Tests: The transplant doctors will ask for any special tests they think you need. For example, people with diabetes need more tests for their heart. Your transplant coordinator or dialysis doctor can help you arrange these tests.


Clinical Laboratory Tests

Blood Typing: There are four blood types: A, B, AB, and O. Every person has one of these types. The donor's blood type does not have to be the same, but it must be "compatible" with your blood type for you to receive their kidney and pancreas.
Viral Testing: We need to know if you have been exposed to hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV), or acquired immune deficiency syndrome (AIDS). We will test you for these at your clinic appointment.

Kidneys for transplant come from two possible sources: 

A living donor: A relative, friend, spouse, or a "Good Samaritan" can be a living donor. Even if your donor isn't a perfect match, they can help you. Through our partnership with the National Kidney Registry, you will have access to a national network of organ donors. Both you and your donor must complete all necessary testing and be approved by the transplant team. Your transplant coordinator will discuss this option during your first clinic visit. Suppose there isn't a potential living donor. In that case, your evaluation will proceed, and you will be placed on the waitlist for a deceased donor organ (see below). Both are excellent options with excellent outcomes. Learn more about becoming a living kidney donor.

A deceased donor: Deceased kidney donors are healthy kidneys from donors who died from other causes - usually an accident or sudden illness. Any unusual donor characteristics will be discussed with you if you are a potential recipient of that donor's kidney.

Kidneys from deceased donors are allocated according to the United Network for Organ Sharing (U.N.O.S.) policy. Factors that contribute to the allocation process include ABO blood type, antibody levels, and waiting list time. 

Suppose you are accepted as a transplant candidate. In that case, your name will be placed on the U.N.O.S. waiting list at Intermountain Medical Center. The kidney transplant waiting list is a list of transplant candidates maintained by U.N.O.S. You will begin to build up waiting list time on the day you are listed — you will receive a letter telling you that date. Your nephrologist will monitor your health when you are on the waiting list. 

The average waiting time for a kidney transplant at Intermountain Medical Center averages just over two years, depending on several different factors:

ABO blood type: The kidney needs to come from a donor with a compatible blood type. 
Your antibody level: This measures the strength of antibodies within your system. A high level of antibodies makes it more difficult to find a donor who is compatible with you.
The availability of an organ.

When a donor organ becomes available, the transplant coordinator will call you. You will always have the right to decline an organ. If the surgeon determines the organ to be unusable, or if there is an incompatible crossmatch, you will be discharged home without the transplant. 

Certain conditions in the donor may affect the success of your kidney transplant. These include the donor’s history, the condition of the organ when it is received, and the potential risk that you may contract infectious diseases or cancer if the doctor cannot detect them in the donated kidney.

Twenty-six million Americans, or one in every nine people, are afflicted with Chronic Kidney Disease (CKD). CKD can affect a person at any age. Still, people who have diabetes or high blood pressure are especially at risk for developing this disease. CKD can progress to the point where the kidneys fail, known as End Stage Kidney Disease (E.S.K.D.). When this happens, a person has two treatment options: dialysis or kidney transplant.

 

The National Kidney Foundation estimates that about 350,000 people in the United States have end-stage renal disease, and about 67,000 people die of kidney failure every year. Since the first kidney transplant in 1967, the success of this procedure has grown to the point that transplant is accepted as the preferred treatment for E.S.K.D. over dialysis.

 

The most common types of kidney disease referred for kidney transplantation are listed below with links to more information:

• Polycystic Kidney Disease (PKD): A genetic kidney disorder that causes cysts to form on the kidneys, eventually leading to E.S.K.D. 
• Diabetic Nephropathy: Lowered kidney function due to complications from diabetes mellitus. 
• Glomerulonephritis (G.N.): Damage to glomeruli (filtering capillaries found within the kidneys). 
• Hypertension (H.T.N.) or high blood pressure: Over time, elevated blood pressure can damage the blood vessels in the kidneys, causing them to stop filtering the blood.

 

Educational Resources

• My Transplant Coach: An educational website to help patients understand the options available to those needing a kidney transplant.

 

Financial Resources

• National Transplant Assistance Fund: Provides emergency one-time grants for patients who have had a transplant.
• Social Security: Financial assistance for patients who will be disabled for at least a year and have enough "work credits." S.S.I. and S.S.D.I.
• Cameron Siemers Foundation for Hope: Provides $5000 grant if you are between the ages of 18-28 and have been diagnosed with a life-threatening illness to be used to fulfill a dream, goal, or project that you take on to make a difference.
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Medication Assistance

• Rx Outreach: Provides deeply discounted mail-order medications; 90 and 180-day supplies for many medicines.
• Rx Assist: Quick and easy-to-use database of all medication patient assistance programs. If you have trouble paying for a medication, you can do a quick search to find out if there might be an assistance program to help.