When a nephrologist refers a patient to Einstein’s Kidney Transplant Program, the first step is to have the patient undergo a medical evaluation. The evaluation determines if transplantation is the appropriate treatment for the patient. It is also an opportunity for the patient to learn about our program, the transplant process and life after transplantation. The patient meets their nurse coordinator who will support them each step of the way. The initial evaluation, which is a one-on-one personalized visit, is very comprehensive and takes a full day. Patients are invited to bring a relative or friend with them.

In addition to the nurse coordinator, the patient meets with a transplant nephrologist (a nephrologist who specializes in treating patients who are waiting for a transplant or who have had a transplant), a transplant surgeon, a social worker and the financial counselor. At the evaluation, blood is drawn for testing and the nurse coordinator schedules additional tests.

The medical evaluation must be completed before the patient’s name is placed on the transplant waiting list. It is intended to gather as much information as possible in order to make the best match with a donor. On average, a complete medical evaluation for a recipient is completed within three weeks. Additional testing may be required for patients with medical conditions. The evaluation includes:

• Blood Work, including:
  - ABO to determine blood type
  - Screening for viruses, including Hepatitis B&C, chicken pox, HIV and CMV (cytomegalo virus)
  - Routine chemistry hematology including a CBC (complete blood count), and tests to check on liver function and electrolytes in the blood cells
  
• Tissue typing to determine genetic make-up and recipients’ antigens.
  
• Infection screening
  
• Cardiac consultation, including an electrocardiogram (EKG) to make sure there is no underlying heart condition
  
• Chest x-ray to rule out cancer or pulmonary problems
  
• Dental clearance to rule out infection in the mouth
  
• Psychosocial evaluation by a social worker or psychiatrist to make sure the patient is psychologically ready and stable to undergo a transplant
  
• Colonoscopy for patients age 50 and older
  
• Mammogram for women age 40 and older
  
• Pap smear for women
  
• Prostate exam for men

Immunology
Because organ rejection is a grave risk, Einstein’s immunology lab is key to transplantation success for our patients. To ensure the best matches, our highly skilled technicians and physicians perform comprehensive pre-transplant histocompatibility testing, as well as post-transplant immune evaluation services.