What Are the Criteria for Kidney Transplant? How Surgeons Decide if a Patient Will Receive a Transplanted Kidney

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Age

The risks of kidney transplant increase in elderly patients. Some hospitals restrict kidney transplants to patients under a certain age. The University of Texas Medical Branch transplant policy, for example, excludes patients over the age of 70 from receiving a kidney transplant. UTMB explains that this is not a hard and fast rule. If someone over the age of 70 is motivated, able to participate in the lengthy recovery process and otherwise a good candidate for the procedure, the transplant team may make an exception.

Respiratory Condition

The use of general anesthesia affects the respiratory system, so those who have severe respiratory conditions should not receive kidney transplants. This includes patients with chronic obstructive pulmonary disease (COPD), severe asthma and other respiratory disorders.

Liver Condition

The presence of chronic health conditions reduces the likelihood of a successful recovery from kidney transplant. Because the body relies on the liver to metabolize prescription drugs and other substances, one of the criteria for kidney transplant is a lack of disorders affecting this vital organ. Patients with viral hepatitis, cirrhosis of the liver and chronic liver disease are not good candidates for this procedure.

Drug and Alcohol Abuse

The kidneys have several functions, one of which is filtering waste from the blood. Excess alcohol consumption and the abuse of illegal drugs take a toll on the kidneys and can result in additional kidney damage. Patients with a history of drug and alcohol abuse do not make good candidates for kidney transplant. One of the concerns associated with performing on a transplant on a patient with this type of history is that he will relapse after kidney transplant. Continuing to abuse alcohol and drugs will damage the transplanted kidney, resulting in serious complications.

Cancer History

Patients with active cancer do not make good candidates for kidney transplant. Active cancers can spread to the kidneys and other organs. Additionally, the chemotherapy and radiation therapy administered for cancer treatment can damage the organs. If a patient with active cancer were to receive a kidney transplant, the cancer treatment could damage the transplanted kidney. Patients who have completed cancer treatment and remain cancer free may undergo this procedure if they meet all of the other criteria for kidney transplant.

Infections

Chronic infections impact the immune system’s ability to fight infection. After transplant surgery, physicians administer immunosuppressive drugs to reduce the risk of organ rejection. Administering these drugs to someone with an infection could have serious consequences. HIV/AIDS and other systemic infections preclude people with kidney failure from receiving transplanted organs.

Morbid Obesity

Morbid obesity increases the risks associated with surgery and general anesthesia. Someone who is morbidly obese has a greater risk of blood clots, heart attack, stroke and other serious surgical complications. UTMB will not allow someone with a body mass index (BMI) of 35 to receive a kidney transplant.

Heart Disease History

Kidney function and cardiovascular function are linked because of the way the blood vessels supply the kidneys. When someone has heart disease, it increases the risk for blood vessel damage, which reduces blood flow to the kidneys. This results in kidney damage and a decline in kidney function. Someone with extensive heart disease should not undergo a kidney transplant because of the risk for damage to the transplanted kidney.

References

University of Texas Medical Branch: Renal Transplant Criteria

Medscape Today: Evaluation and Patient Selection for Kidney Transplantation