Transplant Work-Up
Kidney transplantation is the treatment of choice for endstage renal disease. Pre-transplant assessment should be carried out before the patient is entered on the transplant waiting list. The assessment serves to evaluate and prepare a patient for transplantation. Clinical examination (include urinalysis, breast, testes and prostate) For the list of routine and elective investigations, please ref
Kidney transplantation is the treatment of choice for endstage renal disease. Pre-transplant assessment should be carried out before the patient is entered on the transplant waiting list. The assessment serves to evaluate and prepare a patient for transplantation.
- Clinical examination (include urinalysis, breast, testes and prostate)
- For the list of routine and elective investigations, please refer to relevant guidelines and your local transplant team protocols
The following conditions will need careful pre-transplant assessment and may require prior therapy or may be regarded as an absolute or relative contraindication for a particular potential kidney recipient:
- Active infection
- Malignancy (the time interval between treatment and transplantation depends on the type, stage, and grade of cancer, and the type of treatment given)
- Pregnancy
- Active organ disease which could limit recipient’s life expectancy
- Non-correctable coronary heart disease
- Lung disease
- Liver disease
- Active/untreated peptic ulcer disease
- Cerebrovascular disease
- Peripheral vascular disease
- Uncontrolled HIV infection
- Uncontrolled psychiatric disease or any disease that has resulted in diminished mental capacity for patients to take responsibility for their actions
- Proven habitual medical non-compliance and/or substance abuse
- Smokers must be encouraged to stop
- Obesity (BMI >35) due to increased risk of complications and shorter graft survival. Exceptions can be made if the transplant surgeon determines that the recipient’s body habitus does not constitute an increased surgical risk
- Age is not an absolute contraindication. A careful risk benefit evaluation must be performed and the patient should be counselled on the increased risks associated with age. It is reasonable to exclude patients whose overall condition places them at an excessive risk of post operative morbidity.
Paget G, Naicker S, et al. Guideline for the optimal care of patients on chronic dialysis in South Africa. South African Renal Society; 2015.