1. How is my care coordinated between Sanford USD Medical Center and my kidney doctor?
2. What happens at the evaluation appointment?
3. What are my transplant options?
4. How do I prepare for transplantation?
5. How long will I be in the hospital?
6. Who will take care of my health needs after I leave the hospital?
1. How is my care coordinated between Sanford USD Medical Center and my kidney doctor?
Each end-stage renal disease patient is assigned a coordinator from the Transplant Team at the time of the initial evaluation. Transplant coordinators are nurses who will be responsible for the overall coordination of your transplant-related care at Sanford.
At the time of the evaluation appointment, the transplant office may request the following information from the referring doctor:
Full chemistry panel
Complete blood count (CBC), differential, platelet count
Hepatitis studies
HIV screening
Blood test for syphilis (VDRL)
CMV titers, herpes simplex titers, EBV titers
Urine culture with sensitivities
Recent electrocardiogram (within 6 months)
Chest x-ray
Pap smear for women candidates
Mammogram for women candidates
PSA blood test for male candidates over age 50, to screen for prostate cancer
Additional tests that may be requested include:
Renal ultrasound
Liver ultrasound/gall bladder ultrasound
Cardiac studies
2. What happens at the evaluation appointment?
An evaluation appointment can be scheduled by calling the Transplant Office at 605-328-9290. During the evaluation appointment, you will meet with the transplant nephrologist, surgeon, transplant coordinator, social worker, financial coordinator and transplant dietician.
A member of the transplant team will perform a complete history and physical, review previous test results and decide if any further tests are required. A team member will determine whether you are a candidate for surgery and address any issues that may affect the surgery itself. The transplant team will communicate with your kidney doctor, keep records up-to-date, and be your contact person to answer questions. Information about the transplant evaluation, listing process and waiting time periods will be provided by the transplant coordinator, as well as the options of live donor or cadaveric transplant. An assessment of your emotional well-being, transportation, housing and financial resources will be made by the social worker with involvement by the financial counselor to ensure a positive transplant experience.
Also during this appointment, blood for tissue typing will be drawn. All other tests, including blood tests, will be arranged according to your provider policy. Potential kidney donors are encouraged to attend this appointment for information and to initiate the donation process.
Tests and examinations that will be performed at Sanford Transplant Services include:
Transplant medical and surgical evaluation
Psychosocial evaluation
Blood typing
Tissue type identification and antibody screening
Tissue type identification, blood type identification, and cross match test of any potential donor
Following the evaluation appointment, each patient's case is presented at the weekly meeting of the Sanford Transplant Selection Committee, which is made up of all members of the renal transplant team. At this time, a determination is made if any other tests are required to ensure the patient's candidacy for transplant. Your coordinator at Sanford will notify you and your referring physician and/or nephrologist of the recommendation made by the transplant team. Upon completion of additional tests with satisfactory results, a patient is placed on the transplant waiting list.
3. What are my transplant options?
The Kidney Transplant Program at Sanford offers both living-related and cadaver donor transplantation. If a patient is accepted as a transplant candidate at Sanford, the possibility of a live-donor transplant is explored and encouraged. With a live donor, a transplant can take place as soon as all tests are completed for the donor and recipient.
Patients who require cadaveric transplantation are placed on the national transplant waiting list. This list has over 60,000 potential recipients on it and is maintained by the United Network for Organ Sharing (UNOS). When a kidney is available, the donor blood type and tissue type are entered into the UNOS computer. Once the best possible match is identified, the Sanford Transplant Center is notified. The average wait for potential transplant recipients who live in the South Dakota area is three years.
While on the waiting list, each patient's health status is followed closely. A monthly blood sample is sent by the dialysis unit and is held at the Tissue Typing Laboratory so that it can be used to test whether the patient is compatible with potential donor kidneys. Close contact between your nephrologist, dialysis unit and Sanford transplant coordinator is essential. Any hospitalizations, surgeries, tests, blood transfusions, infections or change in address and phone number should be related to your coordinator so records are up-to-date if a kidney becomes available. Each patient waiting on the transplant list needs to schedule an appointment at Sanford Transplant Services every 6 months while on waiting for a kidney.
4. How do I prepare for transplantation?
While you are waiting for transplantation, make plans for what your needs will be following surgery. Transportation to clinic visits, assistance at home, and financial issues are the most common concerns. The transplant social worker has a wealth of information and resources available. In addition, keeping active, maintaining good nutrition, and stopping smoking are all important factors to keeping as healthy as you can.
5. How long will I be in the hospital?
Following a kidney transplant, the length of stay in the hospital is usually five to seven days, but can extend to several weeks in more complicated cases. You will be seen daily by the transplant team. Discharge planning is started at the time of admission by the social worker and coordinator with plans for care at home, transportation to clinic visits, and housing, if necessary. Education about all aspects of after-transplant care including medications, clinic visit schedule and daily activities will be provided by the transplant coordinator.
6. Who will take care of my health needs after I leave the hospital?
Follow-up continues as long as the kidney continues to function. Initially, you will be seen several times a week. At about six months, you will be returned to your referring nephrologist. Periodic but less frequent visits to Sanford Transplant Services will continue over time. Your referring nephrologist and the transplant team will work together to provide your care.
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