Pretransplant tests, as well as giving a clear picture of the patient's overall health status, help in identifying potential problems before they occur. They also help in determining whether transplantation is truly the best option. This increases the likelihood of success.
The following procedures help in evaluating a patient's health status:
- Physical exam - Gives the doctor an overall picture of the patient's conditions.
- Chest x-ray - Determines the health of the patient's lungs and lower respiratory tract.
- Complete medical and surgical history - Determines what additional tests may need to be done.
- Electrocardiogram (EKG or ECG) - Determines how well the patient's heart is working and may reveal heart damage that was previously unsuspected.
- Ultrasound with Doppler examination - Determines the quality of the iliac vessels.
- Blood tests - The patient's blood count, blood and tissue type, blood chemistries, and immune system function will all be checked. In addition, blood tests for certain infectious diseases will be performed.
- Blood typing - Every person is a blood type A, B, AB or O. The donor's blood type does not have to be the same as the recipient's blood type, but it must be "compatible" (see crossmatch testing).
- Pulmonary function test - The patient will be asked to breathe into a tube attached to a measuring device, which will reveal how well his lungs are working and determine his blood's capacity to carry oxygen.
- Upper gastrointestinal (GI) series - This will show whether the patient's esophagus and stomach are disease free.
- Lower GI series - Ensures that the patient is free of intestinal abnormalities.
- Renal function studies - Urine may be collected from the patient for 24 hours in order to determine if the kidneys are working correctly. Blood tests such as serum creatinine are also performed to measure kidney function.
- Tissue typing - This test is done on white blood cells. White blood cells have special "markers" that distinguish "tissue type", which are used to find a matching kidney.
- Panel Reactive Antibody (PRA) - A way of measuring immune system activity within the body. PRA is higher when more antibodies are being made. It is easier to acquire a kidney if a recipient's immune system is calm or measures 0%. An immune system may be active from blood transfusion, pregnancy, a previous transplant or a current infection.
- Viral testing - Determines if the patient has been exposed to hepatitis, cytomegalovirus (CMV), Epstein-Barr (EBV), or acquired immune deficiency syndrome.
- Mammogram - X-ray of a woman's breast that can detect signs of breast cancer.
- Pap smear - Cells collected from a woman's cervix that are microscopically analyzed for signs of cancer.
- Echocardiogram - Reveals any abnormalities in the heart.
- Dental Evaluations - You need to have a dental check-up before you will be listed for transplant. Your dentist must tell us that your teeth and gums are healthy. You will also need to be checked by your dentist every year while you are waiting for your transplant.
- Other tests - Any special tests or doctor visits that might be needed for the transplant workup.
Histocompatibility Laboratory Tests
Tissue Typing - This test is done on white blood cells. The white blood cells have special "markers" that tell your "tissue type". You inherit tissue type from your mother and father. This test is used to match a kidney and/or pancreas to you.
Panel Reactive Antibody (PRA) - This test shows how active your immune system is. It is easier for you to get a kidney if your immune system is calm or measures 0%. Blood will be drawn at your dialysis center and sent to our laboratory. Your immune system may be active from blood transfusions, pregnancy, a previous transplant or a current infection.
Crossmatch Testing - This test is done when a donor kidney is available. Your blood is mixed with the donor's blood. If there is no reaction (negative crossmatch) it means you are "compatible" with the donor. If there is a reaction (positive crossmatch), the kidney will not work for you because it is "incompatible".
Other Tests - The transplant doctors will ask for any special tests they think you will need. For example, people with diabetes will need more tests for their heart. Your transplant coordinator or dialysis doctor can help you make arrangements for these tests.
Clinical Laboratory Tests
Blood Typing - There are four different blood types. They are A, B, AB and O. Every person has one of these blood types. The donor's blood type does not have to be the same. However, it must be "compatible" with your blood type for you to receive the kidney and/or pancreas.
Viral Testing - It is important for us to know if you have been exposed to hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV), or acquired immune deficiency syndrome (AIDS). We will test you for these at your clinic appointment.