BEING EVALUATED FOR A TRANSPLANT

Recent articles in major publications have suggested a bias in not offering the option of transplant to all patients. It is important for patients, and their families, who have advanced kidney disease, to see evaluation for a kidney(and in the case of some diabetics a kidney-pancreas transplant) as a right.
In our office at THE KIDNEY GROUP we believe all patients should have the option of transplant presented clearly to them BEFORE dialysis is necessary. Unfortunately, when patients are referred to us late in the course of kidney disease this often has to wait until after dialysis is initiated. EARLY referral to a nephrologist is therefore desirable.
We now know that persons who have the shortest amount of total length of time on dialysis(under 2 yrs) fare better when transplanted. If this option is not presented to you and a referral to a transplant center made ask why. Not happy with the answer? Then change nephrologists. This is your life.
Of course there are a few absolute contraindications such as a very recent history of cancer or a terminal co-existing diagnosis. But that's not all that common. Sometimes a person with advance heart or lung disease is not able to undergo the surgery without great risk or another diagnosis might make long term use of immunosuppression undesirable. Patients can have policies(insurance)that exclude transplant-and for these patients our excellent social workers can sometimes work miracles.
But most patients deserve to be evaluated by transplant experts not simply the local nephrologist. DEMAND IT or find a doctor who will send you.
Age, remote history of cancer, HIV, heart disease-all of these do not exclude you for certain.
Life with a transplant can be wonderful but it has its drawbacks such as long term immunosuppression and cost of drugs. But choosing between transplant and a life of dialysis? To me there would be no hesitation.
If you have advanced renal disease, speak to your doctor and explore the pros and cons of transplant at a transplant center. (Don't let the conversation end with your local physician). If you're on dialysis and transplant was NOT mentioned to you or no referral was made-call the doctors office and make an office appointment to speak to them. Bring a family member with you. Find out why and act on it.
Maybe it sounds a little Pollyanna-forgive me-but few things surpass sitting at my desk and seeing a note on my phone that one of our patients got a transplant. I say go for it.