Indications for kidney transplantation
Factors that can rule out kidney transplantation
- Severe and/or uncorrectable coronary artery disease.
- Severe cardiomyopathy (resulting in a very poor risk for general anesthesia).
- Serious active infection (for example, pulmonary tuberculosis, osteomyelitis, peritonitis or infected hemodialysis graft).
- Recent cancer, such as colon, breast or pulmonary. Exceptions are skin cancers with evidence of complete excision. Patients may be considered for a renal transplant after a disease free interval. Additional considerations are the invasiveness of the tumor and the patient’s age.
- Severe and/or uncorrectable peripheral vascular disease. Patients may be considered candidates after bypass surgery, angioplasty, or other therapy.
- Severe and/or uncorrectable pulmonary disease, such as advanced emphysema, pulmonary hypertension.
- Active peptic ulcer disease. A history of peptic ulcer disease is not a contraindication.
- A history of diverticulitis. These patients should have a prophylactic colon resection prior to a renal transplant.
- Current drug and/or excessive alcohol abuse. (Patient may be considered after a six month abstinence with psychiatric evaluation and negative drug test).
- Serious and incapacitating mental illness or mental deficiency such that the person has very limited ability to comply with a complex medical regimen. Exceptions may be considered, after appropriate treatment or health care arrangements.
- Repeated noncompliance with medical regimen, and/or repeated failure to keep dialysis treatment appointments.
- Confirmed infection with HIV.
- Other infectious processes such as active hepatitis, TB, etc.
- Advanced age is a relative contraindication. Patients in a 65 to 70 year old range may be considered candidates, providing their health is good (other than renal disease). A baseline cardiac evaluation including an echocardiogram is required.