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Help4Health, Registered Nurse
Category: Health
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I am doing research on end stage kidney disease and from what

Customer Question

I am doing research on end stage kidney disease and from what I understand, there is a strict list of requirements that must be met in order for a patient to remain on the transplant waiting list. I was hoping someone might be able to shed some light on how these requirements are determined, as I imagine the requirements differ based on the individual.
Submitted: 4 years ago.
Category: Health
Expert:  Help4Health replied 4 years ago.

Hello Ryan,
Seeing your mention of research, can you please tell me if this is a homework question?

Customer: replied 4 years ago.

No the research I am conducting is not being done for purposes of an assignment.

Expert:  Help4Health replied 4 years ago.

Hello Ryan,

Thanks for writing back.

My name isXXXXX a registered nurse and licensed attorney. Glad to try and help out.

In the United States, there is a centralized system called the United Network for Organ Sharing (UNOS). Its importance really cannot be overstated when talking about organ donation. Now, when it comes to renal (kidney) transplantation, here is a nice explanation directly from the source:

Patients: Q & A About Kidney Allocation Policy

That's a good basic overview directed toward a patient audience. For a more in depth discussion, you would need to please realize that each medical center has its own criteria. If you have a particular name in mind, please just let me know and I'll be happy to give you those details.

If you have a follow-up question or need clarification, please just say the word by using "reply" to reach me.

I hope all works out for you.

Customer: replied 4 years ago.

Thank you for that information.


If I had to narrow it down, I would have to say I',m gathering information primarily from the perspective of the Emory Transplant Center in Atlanta, GA.


Could you let me what type of information you can garner pertaining to the requirements set forth by this institution?

Expert:  Help4Health replied 4 years ago.
Hi Ryan,
Thanks for writing back. Good to hear from you.

Sure, gladly.
That's a great institution you mentioned and enjoys an enviable reputation.
Here is the specific information:

Eligibility Criteria for transplant referral:

• Stage 4 or greater chronic kidney disease (GFR<30ml/min)

• Absence of systemic illness or medical condition that significantly decreases estimated short or long-term survival. Examples of such conditions include severe cardiovascular and/or peripheral vascular disease and disseminated malignancy.

• Ability to comply with a complicated, long-term medical treatment regimen. Other important factors include a strong social/family support system and freedom from active drug or alcohol abuse.

• Adequate financial plan to obtain the required immunosuppressive medications after transplant.

SOURCE: Eligibility Criteria
Hope that helps some more.
Take care,
Customer: replied 4 years ago.

Okay great. I suppose what I am mainly interested in is the 3rd set of criteria (ability to comply with a complicated, long-term medical treatment regimen).


Is this category addressing the healthcare requirements that patients need to maintain in order to remain active on the transplant waiting list?


For instance, I've read that a frequent requirement for patients on the waiting list is to see a dentist at least 2x a year. It's requirements like these that I am referring to.

Expert:  Help4Health replied 4 years ago.
Hey Ryan,
You got it. Yes, indeed, your understanding is quite correct.
It sounds harsh, but it does come down to some stark realities. A prospective transplant recipient has quite a lot to take on in terms of responsibilities. They must comply with the medical regimen (such as the dental appointments you mentioned), be healthy enough to stand a reasonable chance of surviving until the operation and through the recovery period (an extremely difficult and stressful call to make for the medical staff), and demonstrate enough compliance with the criteria to warrant inclusion on the waiting list.
Beyond the purely medical and scientific considerations, there are many political and societal issues surrounding this topic. If you haven't already seen it, I thought you might be interested in this article from The New York Times:
In Discarding of Kidneys, System Reveals Its Flaws

Customer: replied 4 years ago.

Wow that's interesting.


Are the requirements to stay on the list different between patients at the same transplant center or will they vary? For example, if you and I were both ESKD patients at Emory, would we both have the same requirements to remain active on the transplant list or is that not necessarily true?


And similarly, how are the requirements tracked (how do patients know that they are complying with all the requirements)? I know that tracking their health targets is an area of concern.

Expert:  Help4Health replied 4 years ago.
Hey Ryan,
It's been great interacting with you and I've thoroughly enjoyed our dialog.
Could I please ask you to rate favorably if you have found my research and answers have been helpful to you?
I've been happy to provide clarification and answer follow-ups, but if you could please help me abide by site rules and post your new questions in a separate thread I would greatly appreciate your kindness.
Just type in the text box on the left side of the web page, please:
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Thanks so much!