A premier center for kidney transplant care for those in West Virginia and beyond

All care begins with a referral. Referrals may be accepted from another healthcare provider, dialysis units, or even from patients (self-referral).

During the referral process, representatives from WVU Transplant Alliance will review medical records and testing, provide pre-evaluation education, and explore whether each patient is ready to move on to evaluation. The financial team will work with your insurance provider to obtain authorization for the evaluation. This pre-evaluation process can help you decide if transplant is right for you.

DID YOU KNOW? To be considered for kidney transplant evaluation, you must:

• Have been diagnosed with end-stage kidney disease (ESRD)
• Or have a diagnosis of chronic kidney disease (CKD) with a glomerular filtration rate (GFR) of less than 25. (GFR is a test of how well the kidneys are working. Transplantation cannot take place until GFR is under 20.)

To make a referral, visit the WVU Medicine Provider Hub or contact the WVU Medicine Transplant Alliance at 304-974-3004. Download the Kidney Transplant Program Evaluation Consultation/Referral Request Form.

During evaluation, patients will be paired with a pre-transplant coordinator as a partner and guide throughout the pre-transplant process.

During your half-day (four to six hours) evaluation appointment, you and your support person will meet our transplant team, which includes a:

• Coordinator
• Dietitian
• Financial coordinator
• Nephrologist
• Pharmacist
• Social worker
• Surgeon

The transplant team will work together to evaluate your overall health and medical, surgical, and psychosocial histories.

During your evaluation, each discipline will provide ongoing transplant education, including a thorough review of the transplant evaluation process and what to expect following transplantation. If the evaluation moves forward, you’ll then visit the Physician Office Center (POC) lab for initial blood work.

Soon after the initial evaluation visit, you will receive a list of required tests and/or potential healthcare provider appointments that need completed as part of the evaluation process. The team will review your medical records to determine what is necessary for evaluation in an effort to avoid repeating tests or appointments that may have already been completed. The sooner the evaluation requirements are completed, the sooner you can move along in the process.

Once all evaluation requirements are complete and all results are received, the pre-transplant coordinator will schedule your case to be reviewed at the next Patient Selection Committee Meeting (PSC). The PSC consists of everyone on the kidney transplant team, including those you may not have seen in clinic. This group will thoroughly review all test results (lab work, radiology testing, cardiac testing, etc.), status of requests from team members during the evaluation day, and any outside consult notes.

The outcome of this meeting will be one of the following:

• Accepted – You will be added to the waitlist pending tissue testing (HLA) and insurance approval. This may take around one week. The financial coordinators will work with your insurance company to obtain approval for kidney transplantation.
• Deferred – Additional testing/information is needed before moving forward.
• Declined – Declined cases may have one of two possible outcomes. “Modifiable” cases will include further instructions on the pathway to becoming a transplant candidate. “Non-modifiable” includes an explanation as to why candidacy is not possible.

Following this decision, the pre-transplant coordinator will guide you through the next steps.

The pre-transplant coordinator will contact you to let you know you’ll be added to the waiting list for kidney transplant. The wait for a kidney can be as long as three to five years but varies for each person. The United Network for Organ Sharing (UNOS) decides how organs are distributed, with decisions based on patient health, blood type (O, A, B, AB), wait time, and Estimated Post Transplant Survival (EPTS).

Learn more about EPTS.

While on the waiting list, there are two statuses you will learn about:

Status 1 – Active

• This means you are actively able to receive a kidney offer. If this is your status, the team must be able to reach you at any time.
• Monthly blood sample submissions are required. Kits will be provided to you. If no sample is received in a timely manner, your status will switch to INACTIVE until one is received.

Status 2 – Inactive

• You are on the list but not receiving offers. This may be due to a GFR above 20, insurance changes, illness/medical status, or a personal choice (travel, no available caregiver, etc.).

KDPI Explained – The Kidney Donor Profile Index (KDPI) is a measure of how likely and how long a donated kidney will work.

Learn more about KDPI.

WAITING

Deceased Donor: When you receive an organ offer from a deceased donor, the transplant coordinator will contact you. The transplant coordinator will discuss the organ offer with you, providing the following details: type of deceased donor, KDPI, and any other pertinent information so that you and/or your family members can decide whether or not to accept this organ offer. The transplant coordinator will also ask about your current health status, ensuring that you are well enough to receive a transplant at the time of the offer.

If the offer is accepted, your transplant coordinator will continue to be your point-person until you arrive in your hospital room at WVU Medicine J.W. Ruby Memorial Hospital. The coordinator will provide you with instructions on when to arrive at the hospital and where to meet upon arrival. Finally, a coordinator will escort you to your room, ensure all preparations are in place, and connect you with your unit nursing team.

If you refuse the organ offer, you will remain on the UNOS waitlist for other future offers.

Living Donor: During a living donor transplant, your surgery will be scheduled at a time that’s convenient for both the donor and recipient. Once the transplant date and operating room are confirmed, you will both attend a scheduled, in-person visit at the WVU Medicine Transplant Alliance and in the Pre-Anesthesia Department approximately two to three weeks prior to the surgery day. Consents and additional blood work will be done at this visit.

On the morning of the transplant, you’ll receive a special soap to wash with ahead of your arrival time. You’ll receive additional details as they’re confirmed leading up to the
transplant day. If either the donor or recipient is ill on the day of surgery, the transplant will be postponed.

OPERATION

During the kidney transplant procedure, you will be placed to sleep under general anesthesia. Once asleep, you’ll receive a breathing tube (ventilator), intravenous line (IV), a urinary catheter (Foley), and a tube to keep your stomach empty and drain fluids that may collect during surgery. Your transplant surgeon will create an incision in your abdomen and/or your side where the newly donated organ will be placed. Your own kidney may or may not be removed based on the surgeon’s discretion. You will remain on a ventilator until you are awake and breathing on your own.

YOUR HOSPITAL STAY

After surgery, care teams will wait for you to awake in the PACU (post-anesthesia care unit). You will then return to the kidney transplant floor where the transplant team will monitor your progress. The hospital stay will usually only be two to four days, during which you’ll learn about post-discharge care at home, necessary medications, and what side effects to watch out for. The post-transplant coordinator and transplant pharmacist will visit to provide this information, while our team works behind-the-scenes preparing for your discharge.

The unit nursing staff will review medications as they’re provided and encourage you to get up and walk in your room and/or the hallways.

You will be advised stay within one hour of the hospital for at least two weeks, but possibly up to four weeks. The transplant team is available to answer any questions you or your loved ones have.

All questions are important – do not be afraid to ask.

After discharge, you’ll need a caregiver for two weeks or more following transplant for daily care, medication management, and traveling to and from appointments. The transplant team will rely on you and your caregiver to let us know of any changes. You’ll need to closely monitor your abdominal incision for signs of infection (redness, puffiness, drainage, puss, fever, etc.), and let our team know right away if something is not right. If there is a change in your urine output (color, volume, or smell) or if you experience any medication side effects, it’s necessary to reach out.

For the first several weeks…

Drink and eat properly. Now that you have a new kidney, you will need to stay hydrated. An increase in hydration will also minimize the risk of constipation after surgery. Eating a healthy diet can also help promote wound healing.

Avoid Illness. Patients who have received organ transplants have a higher risk of infections. To prevent illness, we advise transplant recipients to:

• Avoid hot tubs, saunas, or steam baths
• Avoid any new tattoos or piercings
• Avoid contact with animal feces or soil
• Keep environment free of clutter and dust
• Limit visitors and avoid crowds
• Maintain proper hygiene
• Practice food safety when preparing meals
• Use protection during sexual activity
• Wash hands frequently (especially before touching incision)

Restrictions – You may need to restrict activities or modify your lifestyle as you heal post-transplant. While you can learn more about post-discharge care in our patient resources section, here are a few general rules:

• Avoid contact sports, as this might cause injury to your new kidney. If you have any questions regarding what activity you should or should not avoid, talk with your transplant coordinator.
• Avoid driving for at least six weeks following surgery. We recommend that you always wear your seatbelt when in a moving vehicle.
• Avoid lifting heavy objects and strenuous physical work for at least three months following surgery. It is important that you do not lift anything heavier than eight pounds for the first two to three months.

Movement – Exercise is encouraged, as movement can lower the risk for developing complications such as blood clots or pneumonia. Our team recommends starting with walking or light stretching exercises. As you recover from surgery, you can increase activity to include jogging, hiking, bicycling, golf, swimming, and aerobics.

Fluid Intake and Urine Output – Transplant recipients are asked to monitor their input and output (I&O’s) to make sure any liquids being consumed are also coming out. Logs need to be kept for the first four weeks and brought to clinic during appointments.

2x Weekly Appointments – For the first several weeks, you’ll visit the outpatient transplant clinic on the fourth floor of the Physician’s Office Complex (POC) at least twice a week. When you arrive, you will stop at the outpatient lab on the 1st floor for blood work before heading up to the clinic (or as directed by your coordinator). During your appointment, you will see one of the Transplant Coordinators and a physician. Your coordinator can arrange for you to see other team members as necessary.

WVUMyChart – WVUMyChart is a great way to track your labs and view what results your coordinator will be seeing. Process times for ordered tests vary— unless something is abnormal, your coordinator will not reach out until everything is complete. If you had labs done but don’t see them in WVUMyChart, please call the office and let them know so we can call for results.

As you improve, you’ll be permitted to return home – blood work will continue and can be done closer to home. Appointments will eventually become less frequent, but our team is always here to answer any questions or concerns.

It is sometimes necessary to stay locally in Morgantown while you recover. If you need lodging, WVU Medicine works together with the Rosenbaum Family House to secure reduced rate rooms located on the campus of J.W. Ruby Memorial Hospital. If rooms are not available, they can help locate a discounted hotel room near the hospital.

Learn more about the WVU Medicine Rosenbaum Family House.