If you would like to be considered for a kidney or pancreas transplant, you will receive a comprehensive evaluation. The process includes patient education, medical records review, patient examination, and often additional medical testing. You will meet with several members of the transplant team, including a transplant coordinator, nephrologist, surgeon, and social worker, and also attend an education class on transplantation. The evaluation appointment involves blood work, a chest x-ray, and an EKG. Our multidisciplinary transplant team then reviews your case and decides whether you are a good candidate for transplant, and whether any additional testing may be required to establish your candidacy. If you are eligible, our goal is to list you within 90 days of your evaluation.
Diagnostics for Kidney and Pancreas Transplants
Each member of the multidisciplinary team at the University of Michigan Transplant Center is a specialized expert dedicated to transplant patients. That includes our subspecialist radiologists. Our Biopsy Clinic is open five days a week and we perform approximately 20 kidney biopsies per week. All biopsies are read on the same day they are performed by specialized renal pathologists. Specialists working in our Histocompatibility Laboratory deal with tissue typing and detection of antibodies, which is very important in not only determining which donors are compatible for potential recipients but also in managing transplants.
The Transplant Coordinator: Your Partner in Care
Our dedicated transplant coordinators are the first contact for patients. You are assigned a specific coordinator who will be your point person for anything regarding your care, all the way from pre- to post-transplant. Their responsibilities include answering questions, completing everything needed for you to be listed, ensuring all periodic testing is scheduled, helping with medications, and alerting your medical team if you are having treatment for any other health issue. They also serve as your liaison to the doctors.
Supporting You and Your Family
One of our greatest priorities is to provide education and support to you and the people who will be supporting you before and after transplant, as well as to our live donors. We provide Patient Education Guides and Videos, offer a Transplant newsletter, and host family education classes. For potential donors, we have created a donor-mentoring group, and are in the process of creating the same program for recipients in collaboration with the National Kidney Foundation of Michigan. We also have an initiative called Explore Transplant for Dialysis Unit personnel, training the staff about kidney transplant, so they can be a first line of contact for patients who may need to consider this option.
Medical Care for Kidney and Pancreas Transplant Candidates
Once you’ve been listed, our team will provide ongoing monitoring of your medical care and health to ensure that you are as healthy as possible for your transplant. This care is individualized to your specific needs, and includes testing as needed, and communicating with your local nephrologist.
Once a Donor Organ Is Available
When a donor organ becomes available, you will head to the hospital. The surgery is performed the same day you check in. The vast majority of the time, your own kidneys are not removed as it’s typically not necessary. The new kidney is placed in the lower abdomen or pelvis and the pancreas is also placed in the pelvis. If you are getting a kidney and a pancreas, the transplants happen at the same time. Following the operation, you will go to the recovery room for four hours and then to the hospital room. Ambulation is important for a quicker recovery, so we will get you up and walking, usually the same day as the surgery. Much of the patient and family education takes place while you are still an inpatient. You may be discharged between two and four days after the procedure, depending on how smoothly you recover from the operation. You will most likely go home on the third or fourth day following the transplant surgery.
Post-Transplant Follow-up Care
You will be seen frequently in the clinic on the third floor of Taubman Center for the first three months following transplant. An individual plan will be developed for you, which may require you come to the clinic weekly. Eventually, you will be transitioned to the care of your local nephrologist, who was caring for you before your transplant. At that point you will still need a transplant clinic visit every three or four months at University Hospital but eventually these visits will only be needed once or twice per year.
Taking your anti-rejection medicine is critical to the success of the transplant. During your clinic visits, we will draw blood to check your blood chemistries and drug levels to ensure you are getting the proper medication and that the transplant is performing well. Kidney rejection is often silent and can only be picked up through a blood test. If we pick it up early, we can usually reverse the rejection with treatment. We will also talk about other types of medications you may need due to conditions that can develop from the transplant, along with verifying if medications you were taking before transplant are still required or need to be modified.
To make an appointment to evaluate your need within our Transplant Center, call a patient care representative at 1-800-333-9013. Find a University of Michigan kidney-pancreas transplant doctor.