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Stage 1: Referral
The referral stage begins your journey toward a possible kidney transplant.
In this stage, your nephrology or dialysis doctor will send a referral to the Pre-Transplant Clinic. The Clinic will then send you a welcome package. Please read the package carefully.
Transplantation checklist
The transplantation checklist is a booklet in your welcome package that you will refer to regularly.
The checklist includes the list of important diagnostic tests, like blood tests and imaging.
Your nephrology or dialysis doctor will help decide which tests you need to complete. They will order
and help schedule the tests.
Please attend your appointments
It is very important to go to all the appointments on your checklist because the results help the team understand transplant is a good option for you. If you need to reschedule an appointment, please let your team know right away.
Stage 2: Evaluation
Once you finish all the tests in your transplant checklist, the Pre-Transplant Clinic will call you to book your clinic evaluation appointment.
The appointment is about one hour long.
During the visit, you will meet with a pre-Transplant Clinic nurse, transplant doctor and a transplant resident or fellow ,
During the appointment, the team will:
- Review your health history.
- Go over your medications.
- Look at the results of your transplant checklist tests.
- Talk with you about whether a transplant is a safe and good option for you.
If transplant is right the treatment for you, the pre-transplant team will put you on the transplant waitlist.
Stage 3: Waitlist
Once your transplant doctor has decided that a kidney transplant is a good option for you, they will add your name to the transplant waitlist with Trillium Gift of Life Network.
Keep your information up to date
Please contact us if your phone number or other contact details change. The transplant team must be able to reach you right away when a kidney becomes available.
Please also let us know if you have travel plans.
Waitlist wait times
Once you are on the waitlist, you may get a transplant quickly, or you may wait many years. Most people wait two to six years on the waitlist for a kidney transplant.
Many things can affect your wait time:
- Your blood type (some are easier to match than others).
- Your antibodies, which can make matching easier or harder.
- How long you have been on dialysis (more time on dialysis can move you higher on the list).
- Having a living kidney donor, which can help you get transplanted sooner.
Staying healthy while you wait
While waiting for a transplant, it is important to stay as healthy as possible so that you’re ready for surgery.
If you have trouble with… | Your team can support you by… |
| Eating well | Referring you to a dietician that works in dialysis units and nephrology clinics. |
| Taking your medication | Helping you find strategies to be consistent. |
| Getting to your medical appointments | Connecting you to a social worker who can help you find options. |
| Finding financial support | Connecting you to a social worker who can help you find options. |
Changes to your health
Please contact the Pre-Transplant Clinic if you have had any changes to your health, including:
- Blood transfusions.
- Vaccines with live virus (such as the shingles vaccine).
- Any surgery or diagnostic procedure.
- Heart or blood vessel problems.
- Any serious infection or a fever needing antibiotics.
- Cancer diagnosis or treatment.
- Admission to the hospital.
- Change in medication coverage.
Diagnostic tests
Your team will schedule you for regular tests to make sure you are healthy enough for a transplant and can stay on the waitlist. These tests could include:
- Cytotoxic antibody screening. (HLA PRA) every three months (February, May, August and November each year).
- Hepatitis, HIV and HTLV testing every year.
- Herpes, Epstein-Barr virus, cytomegalovirus and syphilis every year.
- Diagnostic screening such as a transthoracic echocardiogram.
- Cardiovascular Doppler ultrasound of the legs.
- Non-contrast CT of the abdomen and pelvis.
- CT of the chest.
- Abdominal ultrasound.
- Exercise treadmill stress test.
- Nuclear stress test.
- Colon cancer screening with FIT.
- Mammogram.
- Pap smear.
- Tuberculosis skin test (Mantoux).
“On Hold” status on the waitlist
Sometimes you may not be healthy enough to receive a kidney. If that is the case, your medical team may place you “On Hold” while they work on getting you healthy.
You will continue to gain wait time and move up on the waitlist, but you will not receive offers for a kidney until you are medically ready.
Reasons you may be placed “On Hold” on the waitlist
- Active cancer.
- Unresolved infection.
- Heart or vascular problems.
- Current hospital admissions.
- Diabetes complications.
- Concerns about medication adherence.
- Questions about suitability.
- Gastrointestinal disorders.
- Hepatitis C treatment.
- Identified living donor evaluation.
- Immunization(s) needed.
- Inadequate drug coverage.
- Investigation for possible cancer.
- Major surgery.
- Not medically ready.
- Travel or being out of the country.
- Patient preference.
- Patient doing too well clinically.
- Psychiatric illness.
- Need for staged kidney surgery.
- Stroke.
- Weight loss required.
The Pre-Transplant Clinic team will call you if you are placed “On Hold,” and will call again when you are active on the waitlist.