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Kidney Transplant Program

2013 marked the 50th Anniversary of Cleveland Clinic’s first kidney transplant. Cleveland Clinic performed Ohio’s first kidney transplant in January 1963. During that same year, Cleveland Clinic also launched its pediatric kidney transplant program. Affiliate programs have also been established at the Charleston Area Medical Center in West Virginia (1987) and at St. Vincent Indianapolis Hospital in Indiana (2008).

In 2012, Cleveland Clinic staff completed 165 kidney transplants. As of December 31, 2012 a total of 3,892 kidney, 197 kidney/pancreas, 63 kidney/liver, six kidney/heart and one kidney/intestine transplants have been performed at Cleveland Clinic.

Cleveland Clinic kidney transplant program is an essential component of a broad medical and surgical strategy to manage all patients with kidney disease with the therapy most appropriate to that patient, up to and including kidney transplants.

Why choose Cleveland Clinic for your kidney transplant?

A kidney transplant brings an end to seven years of dialysis treatments for Shari Mosley.

Cleveland Clinic is one of the nation's best overall hospitals, according to U.S. News & World Report's 2013-14 "America's Best Hospitals" rankings. Cleveland Clinic is ranked No. 4. This year, Glickman Urological & Kidney Institute is ranked 2nd in the country, and Cleveland Clinic is also recognized for excellence in most of the other medical specialties ranked by the magazine.

Cleveland Clinic kidney transplant program is a member of the United Network For Organ Sharing (UNOS), meeting all their requirements for kidney transplants.

If you or a loved one would like a second opinion from a top specialist at Cleveland Clinic, but may be disabled or find it too difficult to travel, we offer MyConsult. The MyConsult program is an online medical second opinion that connects you to our physician experts who will review your medical records and diagnostic tests to assess your suitability for transplant.

For More Information

Please contact our pre-transplant office for additional information on kidney transplantation:
Phone: 216.444.6996
Toll-free: 800.223.2273 ext. 46996

Indications for Kidney Transplant

Patients must meet certain basic criteria in order to be considered a potential transplant candidate. These criteria are different depending upon the type of organ(s) needed. These basic criteria are just the initial indicators. All patients must be fully evaluated by the transplant team to determine if transplantation is the best treatment option.

The following patients may be considered potential candidates for kidney transplantation:

Relative Contraindications to Kidney Transplant

There may be times when transplantation is not the best treatment option for patients. Patients will be considered on an individual basis to determine whether the benefits of transplantation will outweigh the risks.

If you have any questions regarding whether you or one of your patients is a potential transplant candidate, please contact our pre-transplant office locally at 216.444.6996 or toll-free 800.223.2273 ext. 46996.

Cleveland Clinic has designated facilities and support services to assist patients and their families throughout the entire transplant process. Transplant patients at Cleveland Clinic receive the highest-quality medical and nursing care.

Patient Referrals

The transplant process begins with the patient’s referral to the kidney transplant program. Patients may be referred by their nephrologist or dialysis unit, or they may contact the pre-transplant office themselves.

Contact the pre-transplant office to begin the referral process locally at 216.444.6996 or toll-free 800.223.2273 ext. 46996. Patient referrals can also be faxed to the kidney transplant program at 216.445.8141.

Our secure online service, Dr.Connect, provides referring physicians access to patient’s treatment progress with streamlined communication from Cleveland Clinic physicians to your office, allowing continued participation in the ongoing care of patients. With the best possible treatment plans and coordinated care, our team approach benefits both the patient and the referring physician.

Patients will complete a medical interview over the phone with a member of the pre-transplant department staff.

A letter will be sent to the patient and referring physician indicating the routine health maintenance testing necessary prior to beginning the evaluation process. The most efficient way to progress through the evaluation is to have this testing completed prior to the initial evaluation appointments. Testing completed within the past year is acceptable (PAP test & colonoscopy may be longer depending upon results/recommendations).

  • PAP test – all females age 18 and older
  • Mammogram – all females age 40 and older
  • Colonoscopy – all patients age 50 and older
  • Cardiac Stress Test – all patients age 40 and older
  • Chest X-Ray – all patients
  • Dental Clearance – if required by insurance
  • Nutritional Evaluation – all patients on dialysis (a form will be sent to the patient)

Patients that are actively smoking will be offered a screening visit with one of the transplant nephrologists and a referral to Cleveland Clinic’s smoking cessation program. Patients will be considered for a full transplant evaluation following program completion. Patients with a Body Mass Index (BMI) above 38 will be offered a screening visit with one of the transplant nephrologists and a referral to the Bariatric Institute for development of a weight reduction program. Patients will be considered for a full evaluation once their weight loss goals have been met.

Transplant Evaluation

Patients will be scheduled to see the transplant team to assess their transplant candidacy.

The evaluation will consist of:

  • Medical Evaluation
  • Evaluation
  • Psychosocial Evaluation
  • Transplant Education
  • Financial Evaluation
  • Labwork and CT Scan of the abdomen and pelvis

Based upon the physicians’ findings during the evaluation appointments, additional testing and consults may be needed. Once the evaluation is complete, the patient’s chart will be reviewed by the physicians and then the patient will be presented at the selection committee. The selection committee may approve the patient for listing, require additional information prior to making a decision, or determine that the patient is not a candidate for transplantation. The patient, referring physician, and dialysis unit (if applicable) will receive letters notifying of the committee’s decision.

Once a patient has been approved for transplant listing, insurance authorization will be obtained if needed prior to being placed on the national transplant waiting list.

Waiting for Transplant

Once patients have been placed on the transplant waiting list, it is important that the kidney transplant program be notified of any changes in the patient’s condition such as:

  • Changes in cardiac (heart) or pulmonary (lung) status
  • Active infections
  • New medical diagnoses
  • Hospitalizations
  • Surgeries and procedures
  • Blood transfusions
  • Addition of anticoagulant medications (blood thinners)

It is also important for the transplant program to receive any updated testing results that have been performed on the patient, such as stress tests, cardiac catheterization, carotid ultrasound, CT scans, etc. These results should be faxed to the transplant program at 216.445.8141.

It is very important that patients waiting for transplant contact our office with any changes in their address or phone number. Patients must also contact our Financial Coordinator at 216.444.9806 with any changes in their insurance coverage.

A Team Approach

The Kidney Transplant Team at Cleveland Clinic is specially trained in meeting the needs of kidney transplant patients. The team is committed to providing comprehensive care in a compassionate setting. 

The Kidney Transplant Team members include:

  • Transplant Surgeons
  • Transplant Nephrologists
  • Transplant Coordinators
  • Transplant Fellows and Residents
  • Social Workers
  • Transplant Program Assistants
  • Financial Counselors
  • Dietitians
  • Transplant Psychiatrist
  • Transplant Bioethics
  • Registered Nurses
  • Nursing Assistants

Additional consultants may also include:

  • Cardiology
  • Vascular Medicine or Surgery
  • Endocrinology
  • Infectious Disease
  • Pulmonology

The following Cleveland Clinic Transplant Center doctors and staff specialize in Kidney Transplant:

Kidney Transplant Program Leadership
Kidney Transplant Program Surgeons
Kidney Transplant Program Physicians
Kidney Transplant Program Team Members

Pre-Transplant Coordinators:

  • Valerie Keenan, RN, BSN, CCTC
  • Ragina Bass, RN
  • Melissa Drummond-Young, RN
  • Beverly Alt, RN, CPTC
  • Eva Davis, RN

Procurement Transplant Coordinators:

  • Cynthia Anderson, RN, CCTC
  • Casey Billington, RN, CCTN

Post-Transplant Coordinators:

  • Megan Begala, RN, BSN
  • Margaret Kay Burr, RN, MSN
  • Natalie Keyerleber, RN, BSN
  • Shawn Paschal, RN, BSN, CCTC
  • Elaine Beaver, RN, BSN, CCTC

Nurse Practitioners:

  • Tracy Evans-Walker, RN, MSN, CNP, CCTC
  • Sherry Levy, RN, MSN, CNP
  • Julie Corder, RN, MSN, CNP - Pediatric Nurse Practitioner and Transplant Coordinator
  • Melanie Klein, RN, MSN, CNP - Pediatric Nurse Practitioner and Transplant Coordinator

Kidney Transplant Living Donor Coordinators:

  • Audrey Caplin, RN, BSN
  • Karen Wallenfelsz, RN

Social Work:

  • Trudy Aquilina, ACSW, LISW-S
  • Cheryl Gillespie, LISW-S, MSW
  • Beth Piotrowicz, MSW, LISW-S
  • Audrey Rush, MSW, LISW - Pediatric Social Worker
  • Kelly Vitello, MSW, LISW - Pediatric Social Worker

Department Coordinators/Transplant Program Assistants:

  • Melissa Nalepka - Pre-Transplant
  • Monica Young - Pre-Transplant
  • Jacqueline Prather - Pre-Transplant
  • Susan Mitchell - Living Donor
  • Dragana Komso - Post-Transplant
  • Shoneice Barton - Post-Transplant
  • Beverly Suber - Post-Transplant

Financial Coordinator:

  • Donna Eatmon

Clinic Support Staff:

  • Vannessa Walter, LPN
  • Annette Restifo, MA

Where does my new organ come from?

Organs for kidney transplantation come from two sources: living donors and deceased donors.

Deceased Donor Kidney Transplant

A deceased donor is an individual who has recently passed away of causes not affecting the organ intended for transplant. Deceased donor organs usually come from people who have decided to donate their organs before death by signing organ donor cards. Permission for donation also may be given by the deceased person’s family at the time of death.

A deceased donor kidney transplant occurs when a kidney is taken from a deceased donor and is surgically transplanted into the body of a recipient whose natural kidneys are diseased or not functioning properly.

Types of Deceased Donor Organs

There are several different types of deceased donor kidneys. These names are used to describe certain anatomic, biological, and social features of the donor organs. You may decide not to receive any or all of these organs, and you may change your mind at any time.

  • Standard Criteria Donors (SCD): These kidneys are from donors under age 50 and do not meet any of the criteria below that are assigned to Expanded Criteria Donors.
  • Expanded Criteria Donors (ECD): These organs come from donors over age 60 or age 50-59 that also have at least two of the following criteria - history of high blood pressure, the donor passed away from a CVA (stroke) or had a creatinine higher than the normal laboratory value (1.5 mg/dl). About 15-20% of the donors in the United States are Expanded Criteria.
  • Donation after Cardiac Death (DCD): These donors do not meet the standard criteria for brain death. Their hearts stopped before the organs were removed. Donation after Cardiac Death occurs when continuing medical care is futile, and the donor patient is to be removed from all medical life-sustaining measures/supports.
  • Double Kidney Transplants (Duals): During the year we may have access to donors that are at the more extreme limit of the Expanded Criteria Donor. Research has found that using both of these kidneys in one recipient is preferable to only one.
  • Donors with High-Risk Social Behavior: These donors are individuals who at some point in their life practiced high-risk behavior for sexually transmitted disease, drug use, or were incarcerated. All of these donors are tested for transmissible disease at the time of organ recovery. You will be informed of the high-risk behavior.

All of these kidneys supply suitable organs for transplant, and all are expected to provide good outcomes with good organ function. However, the outcomes may be 5-10% less than that achieved with Standard Criteria organs. Accepting a kidney that is not considered Standard Criteria may substantially reduce your waiting time.

Living Donor Kidney Transplant

A living donor transplant is a procedure during which a kidney is removed from a healthy donor and surgically placed in an individual with kidney failure. The living donor often is an immediate family member (parent, sibling, or child). The living donor can also be an uncle, aunt, cousin, or even a spouse or friend. Living donor kidneys can also come from strangers, Good Samaritans that want to help someone in need of a kidney.

A living donor transplant has many advantages over a deceased donor kidney transplant, the most important being a significantly higher success rate. Additional reasons include:

  • A kidney from a living donor generally functions immediately after transplant. A deceased donor kidney might take several days or weeks to function normally.
  • The living donor transplant can be scheduled, allowing the recipient and donor preparation time. You will not know when a deceased donor kidney will be available, and surgery must be performed very soon after it is available.
  • There may be a reduced risk of rejection, especially if the kidney is donated by a blood relative.
  • You might possibly shorten the amount of time you have to wait to receive a kidney transplant. The average wait time for a deceased donor kidney could be three to five years.

Who would be a good living donor candidate?

Biological siblings generally make the best living donors due to matching. However, with the advancements in drugs and treatment for rejection prevention, anyone can be considered a donor if they have a compatible blood type. Most healthy individuals between the ages of 18 and 60 are potential donors. All living donors are evaluated individually. You should discuss donation with immediate and extended family members, friends, co-workers, and friends of friends. The success of kidney transplants using unrelated living donors is nearly as high as living related donors.

All potential kidney donors must demonstrate that the decision to donate is made freely, electively and without coercion or valuable compensation.

The recipient and donor teams function separately. Living donors will have their own coordinator, physicians, and social worker. The Living Kidney Donor Office is unable to answer recipient questions about their living donors. Recipients should contact the pre-transplant office locally at 216.444.6996 or toll-free 800.223.2273 ext. 46996 with questions regarding this process.

If you are interested in being evaluated as a potential living donor, please contact the Living Kidney Donor office for additional information locally at 216.445.3150 or toll-free 800.223.2273 ext. 53150. More information is also available in the Living Donor section of this website.

Throughout the entire transplantation process, the Cleveland Clinic transplant team ensures that you receive the best possible care. Team members are there each step of the way.

Your length of stay and recovery in the hospital will depend on a few factors including: type of transplant procedure, your body's acceptance of the new organ and your overall health. Remember, each patient has a different rate of recovery. You will be discharged only after your Transplant Team has determined that you have regained your strength and your health is stable.

Transplant team members are available after patients have returned home to provide additional information and answer questions. The team also can help with follow-up care, including routine blood testing, medication evaluation and adaptation, and visits to ensure that patients are doing well. Your transplant team will give you instructions on how and when to contact the post-transplant office following your discharge.

Going Home

Taking Care of Yourself

Soon after surgery and during your stay in the hospital, your Transplant Team will teach you more about taking your new medicines. You will learn when to take your medicines, how to take them, what happens if you miss a dose, and what side effects the medicines might cause.

A daily record of your health is kept during your stay at the hospital, and you will need to continue monitoring your health when you go home. Before you leave, a nurse will teach you how to accurately measure both your liquid intake and urine output. To ensure that your kidney is functioning well, you will need to measure and record how much you drink and the amount you urinate for at least six weeks after the transplant surgery. You will also need to record your daily temperature, blood pressure, and weight.

When will I be able to go home?

Our goal is to help you feel comfortable and confident about taking care of yourself before you go home. Before going home, you will need to be able to:

  • Follow your medicine schedule correctly without assistance
  • Take your temperature and blood pressure
  • Keep track of and record your fluid intake and urine output
  • Know whom to call for an emergency appointment
  • Know what problems should be reported to the transplant coordinator

The Transplant Team will be monitoring your health closely after the transplant and during your follow up appointments. Therefore, it is very important to keep your scheduled lab and follow-up appointments.

How should I take care of myself once I go home?

Once you are discharged home, you will need to continue recording your daily temperature, blood pressure and weight in a notebook. It is also very important to keep your list of medications updated.

Remember to keep the records in your notebook for at least six weeks, or longer if you have complications. The Transplant Team will let you know when it is okay to stop recording this information. Remember to always bring your post-transplant notebook and medicines to each Transplant Clinic visit.

What will I need before I go home?

It is important to make sure you have each of these before you go home:

  • Thermometer
  • Blood pressure cuff
  • Scale
  • Medication organizer

To decrease the chance of infection, you must avoid people with colds or flu for at least three months. By avoiding illness now, you will be able to return to an active life within a few months.

Tips for a Healthy Transplant Recovery

Tips for a Healthy Transplant Recovery

  • Take all your medicines exactly as prescribed
  • Keep all of your scheduled appointments with the Transplant Team
  • Call the Transplant Team if you have any questions or concerns
  • Have your blood drawn promptly, as recommended by the Transplant Team
  • Follow your recommended dietary plan
  • Follow your recommended fluid intake
  • Follow your recommended exercise plan
  • Avoid being around anyone who has an infection

Call the Transplant Team if you experience any of the following

  • A fever higher than 100°F (38°C)
  • Flu-like symptoms such as chills, aches, headaches, dizziness, nausea or vomiting
  • New pain or tenderness around the transplant
  • Fluid retention (swelling)
  • Sudden weight gain greater than 4 pounds within a 24-hour period
  • Significant decrease in urine output
What You Need to Know About Kidney Transplant Rejection

What is transplant rejection?

One of the most common complications following a kidney transplant is rejection. Rejection is your body’s way of not accepting the new kidney. Although rejection is most common in the first six months after surgery, it can occur at any time.

Fortunately, the Transplant Team can usually recognize a rejection episode before it causes any major or irreversible damage. It is very important for you to continuously take your medications as prescribed and have your blood work drawn as scheduled.

What are the warning signs of possible rejection?

It is vital for you to be aware of the possible signs of kidney rejection. If you think you are experiencing any of these symptoms, contact the Transplant Team immediately:

  • Fever over 100°F (38°C)
  • "Flu-like" symptoms: chills, aches, headache, dizziness, nausea and/or vomiting
  • New pain or tenderness around the kidney
  • Fluid retention (swelling)
  • Sudden weight gain greater than 2 to 4 pounds within a 24-hour period
  • Significant decrease in urine output

How is rejection identified?

The Transplant Team will be able to determine if your body is rejecting your kidney by completing routine tests of kidney function. If the Team thinks you may be experiencing any problems with your new kidney, the following tests may be completed:

  • Repeated blood work
  • Renal flow scan (which checks blood flow to the kidney)
  • Renal ultrasound (which checks for other physical problems)
  • Kidney biopsy

What is a kidney biopsy?

  • A kidney biopsy is a procedure in which a small sample of kidney tissue is removed and tested.
  • A kidney biopsy is usually performed on an outpatient basis.
  • In order to take a biopsy, or a small sample of tissue, the skin above your kidney is numbed to allow a small needle to pass directly through to your kidney. Ultrasound is used to determine the appropriate location to biopsy.
  • Once complete, a microscope is used to examine the sample of tissue and establish a diagnosis.
  • The actual biopsy generally takes between 20 to 30 minutes.
  • You will be required to lie flat for two hours following the procedure to prevent bleeding.

How is rejection treated?

If rejection develops, your physician may prescribe medications to treat rejection and prevent continued complications. In order to control the rejection, you may need to be admitted to the hospital, or you may receive care in the outpatient setting.

Will rejection treatment cause side effects?

The medications used to treat a kidney rejection episode are strong drugs. The first few doses may cause the following side effects:

  • Fever, chills
  • Headaches
  • Nausea, vomiting
  • Weakness
  • Diarrhea
  • General flu-like symptoms

To help control these symptoms, you may receive a pre-medication of acetaminophen (Tylenol) and diphenhydramine hydrochloride (Benadryl) before each dose.

    Special Care for Pediatric Patients

    Cleveland Clinic’s pediatric transplant program began in 1963 with the goal of providing the most normal life possible for young patients. Pediatric and adolescent patients receiving a kidney transplant are admitted to Cleveland Clinic Children’s. Cleveland Clinic Children’s provides state-of-the-art care in a homelike setting. In addition, because the family is recognized as an important part of a hospitalized child’s recovery, our hospital rooms are designed to enable a parent to spend the night in the room with his or her child.

    For more information on Cleveland Clinic’s pediatric transplant program, please call 216.444.6123.

    A living donor transplant is a procedure during which a kidney is removed from a healthy donor and surgically placed in an individual with kidney failure. The living donor often is an immediate family member (parent, sibling, or child). The living donor can also be an uncle, aunt, cousin, or even a spouse or friend. Living donor kidneys can also come from strangers, Good Samaritans, that want to help someone in need of a kidney.

    A living donor transplant has many advantages over a deceased donor kidney transplant, the most important being a significantly higher success rate. Additional reasons include:

    • A kidney from a living donor generally functions immediately after transplant. A deceased donor kidney might take several days or weeks to function normally.
    • The living donor transplant can be scheduled, allowing the recipient and donor preparation time. Recipients will not know when a deceased donor kidney will be available, and surgery must be performed very soon after it is available.
    • There may be a reduced risk of rejection, especially if the kidney is donated by a blood relative.
    • A living donor transplant can shorten the amount of time a recipient has to wait to receive a kidney transplant. The average wait time for a deceased donor kidney could be three to five years.

    Who would be a good living donor candidate?

    Biological siblings generally make the best living donors due to matching. However, with the advancements in drugs and treatment for rejection prevention, anyone can be considered a donor if they have a compatible blood type. Most healthy individuals between the ages of 18 and 60 are potential donors. All living donors are evaluated individually. You should discuss donation with immediate and extended family members, friends, co-workers, and friends of friends. The success of kidney transplants using unrelated living donors is nearly as high as living related donors.

    What are the risks of having only one kidney?

    A common question from a donor candidate is: “What if I get kidney disease later on in life?” A person with one kidney is no more likely to get kidney disease than someone with two kidneys. Even if the most common forms of kidney disease were to occur, a person with one kidney has no major disadvantage because medical kidney disease attacks both kidneys simultaneously. After surgery, the donor’s remaining kidney will increase in size and function. The donor’s chance for a long, normal, and healthy life remains the same with one kidney.

    Will the quality of life change for the donor?

    Once the donor has healed from the surgery, the person should not experience a difference in energy level, ability to work, life expectancy, susceptibility to illness, sexual function, or feeling of health. Also, donation should not affect fertility. Many female kidney donors have had normal pregnancies after donation. Donors also might receive a certain amount of satisfaction knowing they were able to help save another person’s life. In addition, by giving one of his or her kidneys, the living donor has also made a deceased donor kidney available to another who might not have any other options.

    Is the donor operation dangerous?

    Kidney donor surgery is a very safe operation. As with any surgery, there is a risk of bleeding and infection. The most advanced surgical technique, laparoscopic nephrectomy, has reduced the hospital stay to one or two days, resulted in less pain and scarring, and has reduced full recovery time from eight to 12 weeks down to two to four weeks.

    Who will pay the donor’s medical bills?

    A donor candidate will undergo a complete evaluation to determine if he or she can safely donate a kidney. The recipient’s insurance company will pay for these costs. All costs associated with the donor’s operation and recovery will also be billed to the recipient’s insurance company.

    Once a donor has recovered, he or she will be required to have a follow-up appointment at six months, one year, and two years. A donor also might incur costs of travel, lodging, meals, and other non-medical expenses. Donating an organ is covered by the Federal Medical Leave Act. However, the donor candidate should determine the impact donation will have on his or her work situation before committing to the operation.

    If you are interested in being evaluated as a potential living donor, please contact the Living Kidney Donor office for additional information at 216.445.3150 or 800.223.2273 ext. 53150.

    Living Kidney Donor Evaluation Process 

    Can I be a kidney donor?

    Generally, any normal, healthy adult with two normal kidneys can be a kidney donor. Your blood type will be the main factor in determining who can receive your kidney.

    What blood tests are performed to determine if I am a compatible kidney donor?

    ABO blood type

    First, a simple blood test is performed to determine your blood type and that of the recipient. Here’s how your blood type should be compatible with the recipient’s blood type:

    • If you have blood type A, your recipient should have blood type A or AB.
    • If you have blood type B, your recipient should have blood type B or AB.
    • If you have blood type AB, your recipient must have blood type AB.
    • If you have blood type O, you are a universal donor and can donate to someone of any blood type: A, B, AB, or O.

    Tissue typing

    Tissue typing is a blood test that evaluates the compatibility, or closeness, between your tissues and the recipient’s. A human lymphocyte antigen (HLA) blood test is used to determine tissue type and help ensure that you’re a good genetic match for the recipient. In an HLA blood test, the tissue typing lab can identify and compare information about you and your recipient’s antigens (the “markers” in cells that stimulate antibody production) so they can match your kidney to the recipient.

    While biological siblings (brothers and sisters) have the best chance of being a perfect match (six of six antigens), advancements in anti-rejection medicines have greatly reduced the occurrence of rejection in kidneys from unrelated donors. Researchers are also making strides in the development of treatments that will significantly increase the donor success rate when tissue doesn’t closely match.

    Crossmatching

    In crossmatching, your blood and the recipient’s blood are placed together in a test tube and examined to see if there is cell damage. If all your cells survive, there is a negative crossmatch, which is considered a good result. If your cells begin to die, a positive crossmatch results and gives a preview of what might happen with a transplant. In this case, it may be determined that the risk of proceeding with the transplant would be too high.

    After the blood tests, how will I be evaluated as a potential donor?

    If the initial blood tests indicate you are a suitable match, and you decide you would like to proceed , we will arrange an extensive donor evaluation to ensure you are in normal physical and emotional condition, and to inform you about the risks and procedures of being a kidney donor.

    The evaluation generally consists of two days of outpatient appointments and testing. The evaluation will consist of:

    • Medical Evaluation
    • Surgical Evaluation
    • Psychosocial Evaluation
    • Living Donor Education
    • Financial Education
    • Labwork
    • EKG (electrocardiogram)
    • Chest X-Ray
    • 24 hour ambulatory blood pressure monitor
    • CT Scan of the abdomen and pelvis

    Based upon the physicians’ findings during the evaluation appointments, additional testing and consults may be needed. You will also be asked to update your health maintenance testing if needed:

    • Pap test for women 18 years of age and older
    • Mammogram for women 40 years of age and older
    • Colonoscopy for both women and men 50 years of age and older
    Donor Surgeries 

    Laparoscopic Donor Nephrectomy:

    Minimally Invasive Kidney Removal

    There is an ever-increasing demand for living kidney donors. Until recently, kidney donation from a living donor could only be accomplished through a surgical procedure called open nephrectomy (kidney removal). This procedure requires a large, muscle-cutting abdominal incision; removal of a rib; and a relatively longer hospital stay and recovery period. However, advances in laparoscopic surgery have made an advanced surgical procedure called laparoscopic donor nephrectomy possible. This procedure has significant benefits over the traditional open surgery for kidney donation.

    Laparoscopy—also known as “keyhole surgery”—is a minimally invasive surgical procedure during which a special camera, called a laparoscope, is used to produce an inside view of the abdominal cavity. Surgeons use the laparoscope, which transmits a real-life picture of the internal organs to a video monitor, to guide them through surgical procedures. The laparoscope magnifies these images many times their actual size, providing surgeons with a superior view of the abdomen.

    Laparoscopic nephrectomy is a minimally invasive procedure that uses a laparoscope to remove a kidney for donation. Laparoscopic kidney removal is considered minimally invasive because it only requires three or four small non-muscle-cutting incisions rather than one large muscle-cutting incision in the abdomen. (See figures 1 and 2.) During the procedure, carbon dioxide is passed through one of the incisions into the abdominal cavity to lift the abdominal wall away from the organs below, creating more operating space to perform the surgery. The pencil-thin laparoscope and surgical instruments are then inserted through the other incisions.

    At the end of the procedure, the kidney is removed through a 7cm, non-muscle-cutting incision in the bikini area.

    Surgery Image

    Figure 1: Positions of small incisions for laparoscopic donor nephrectomy surgery. No muscle is cut for any of these incisions.

    Surgery Image

    Figure 2: Muscle-cutting incision (6- to 10-inches long) used in traditional open nephrectomy surgery.

    What are the advantages of laparoscopic donor nephrectomy?

    Because laparoscopic donor nephrectomy is a minimally invasive procedure, donor patients experience significantly less discomfort; have a shorter recovery period, and return to work more quickly than donors who had traditional open surgery. Because the incisions are small, laparoscopic donor nephrectomy causes reduced post-operative pain and shorter hospital stays, and patients experience a quicker return to normal eating habits and daily activities.

    Who is a candidate for laparoscopic donor nephrectomy?

    Most people who are eligible for open nephrectomy are also eligible for laparoscopic nephrectomy. However, you might not qualify for the procedure if:

    • You have had multiple previous abdominal surgeries
    • You are significantly overweight
    • There is abnormal anatomy of the kidney

    The surgeon will complete a pre-operative evaluation to ensure that laparoscopic nephrectomy is appropriate for you. However, in a small percentage of cases, even approved laparoscopic procedures might be converted to open procedures.

    Paired Donation 

    Donors that are not matches to their intended potential transplant candidate have the option of participating in a paired donation program (where your donated kidney goes to a different recipient, and in return your recipient will receive a living donor kidney from another individual). Cleveland Clinic Kidney donors also have the option to donate to a stranger via our altruistic program.

    Cleveland Clinic currently works with National Kidney Registry (NKR) to facilitate paired donor transplants. Altruistic living kidney donors can also be entered into the NKR program. National Kidney Registry is a nonprofit organization based out of Long Island that was established to expand the opportunities for living donor kidney transplants through paired donation. More information can be found at kidneyregistry.org.

    If you are interested in learning more about the paired donation or altruistic donation programs, please contact the Living Kidney Donor office locally at 216.445.3150 or toll-free 800.223.2273 ext. 53150.

    Donor Win® Program 

    Cleveland Clinic has developed an innovative program called Donor Win (short for Donor Wellness Initiative) to monitor and foster wellness in living kidney donors. This program was launched in November 2009 and provides living kidney donors with support, testing, counseling, and care for the rest of their lives if they so choose.

    The program includes scheduled follow-up appointments for the living donors at six months, 12 months, and two years after surgery, and then annually thereafter.

    During their follow-up appointments at Cleveland Clinic, donors receive a complete physical exam, as well as extensive lab testing, blood pressure monitoring (including ambulatory blood pressure monitoring) and other cardiovascular physiologic testing that measures their vascular health.

    Donors are also counseled by their nephrologists on how to maintain the health of their remaining kidney and stay well, in general, through diet and exercise. Their physicians, who are specially trained to understand the risks and needs of living donors, also counsel patients on how to deal with any health-related issues that may arise.

    Cleveland Clinic’s transplant center chose to offer living donors a comprehensive program because it wanted to reward and honor those people who are, essentially, saving and improving the lives of people with end-stage renal disease. Donor Win is also unique in that it focuses on maintaining the wellness of patients throughout their lifetime, instead of treating donors as though they have a disease.

    If you are interested in learning more about this program, please contact the Living Kidney Donor office locally at 216.445.3150 or toll-free 800.223.2273 ext 53150.

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    To find a transplant specialist for your needs, contact the Transplant Center at 216.444.2394 (or toll-free 800.223.2273, ext. 42394)

    This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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