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If the patient has no medical contraindications after medical review by the transplant physician the patient will be scheduled for transplant evaluation. The patient will be responsible for scheduling any necessary travel, hotel, or transient hemodialysis needed during the pre-transplant evaluation.

Renal Transplant Evaluation: Day One

A transplant evaluation history and physical performed by the mid-level provider and a letter dictated by the mid-level provider will be sent to the referring nephrologist.

Tests:

• EKG
• Chest X-ray

Team Consult Appointments:

• Mid-level Provider
• Social Worker
• Financial Coordinator
• Dietician - Nutrition Consult
• Pre-transplant Coordinator

Any critical findings on Day One of the evaluation will be communicated by the mid-level provider to a registered nurse at the patient’s dialysis center or directly to the referring nephrologists by phone and the appropriate reports faxed.

Renal Transplant Evaluation: Day Two (scheduled 3 weeks after day one appointment)

Consultations:

• Transplant Surgeon
• Transplant Nephrologist
• Cardiologist (if known history of coronary artery disease which has required intervention such as CABG or angioplasty/stent placement or history of severe cardiomyopathy).
• Mental Health Specialist (if known history of depression, bipolar disorder, schizophrenia, eating disorder, noncompliance, significant substance abuse or any other mental illness).
• Hepatologist (if known history of hepatitis B or C or other liver disease).
• Hematologist (if known history of sickle cell anemia or other hematologic disease).
• Pulmonologist (if known history of COPD or sleep apnea). 

Additional Studies:

• Colonoscopy: Required in all patients over the age of 50 who have not had a colonoscopy in the last ten years.
• Pap Smear and Gynecological examination: Required in all women and should be performed within one year of the transplant evaluation and maintained yearly.
• Mammogram: Required in all women over the age of 35 and should be performed within one year of the transplant evaluation and maintained yearly.
• MRI or CT of the abdomen and pelvis: Required in all patients who do not have updated abdominal imaging.
• MRA or CTA of the abdomen and pelvis: Required in all patients with diabetes and in all patients with a history of peripheral vascular disease.
• Carotid Duplex: Required in all diabetic patients and in other patients as indicated by medical history or physical examination findings.
• Cardiac testing which may consist of an echocardiogram, a dobutamine stress test or a thallium stress test.
• Additional tests may be ordered as determined by patient history.

A letter to the referring nephrologist will be dictated by the transplant surgeon after Day Two of the evaluation updating the patient’s status.