Kidney transplantation is a major event and a detailed and thorough evaluation of the uremic patient is required before the kidney transplant is selected and the qualified person can receive the kidney transplant. The following examinations are generally required.
The first part is Pre-transplant history taking and physical examination
Pre-transplantation history and physical examination
General conditions causing renal failure, course of the disease, course of hypertension, course of infection (especially urinary tract infection, viral infection or tuberculosis infection), history of previous transplantation
Other diseases cardiovascular diseases, previous and current tumors, respiratory diseases gastrointestinal diseases, liver diseases
Past surgical history nephrectomy, splenectomy, parathyroidectomy, appendectomy and others
Current clinical profile and treatment dialysis patterns and duration of dialysis
Blood pressure control
Urine output
Central nervous system symptoms, signs
Past history of blood transfusion, pregnancy history
appetite, medications
Physical examination
Vital signs and heart and lungs
Abdomen, especially surgery-related areas
Gynecology (female), prostate (male)
Vascular condition
The second part is devoted to laboratory and imaging examinations
Routine and elective tests for pre-transplant evaluation
Routine tests
Selective tests
Blood cell classification and count
Voiding cystourethrography (for patients with urological malformations)
Blood group
Pedal test (for those with high risk factors for coronary heart disease)
Blood biochemistry (liver and kidney function, electrolytes), blood lipids
Coronary angiography (>45 years old, patients with coronary artery disease)
Prothrombin time and partial thromboplastin time
Mammography (>40 women)
Hepatitis B virus markers
Abdominal vascular MRA (diabetic nephropathy patients)
HCV-IgG, IgM
Upper gastrointestinal endoscopy (patients with upper gastrointestinal ulcer, bleeding)
HIV, HSV, CMV titers
Barium enema and lower gastrointestinal endoscopy (patients with bloody stools and chronic stool abnormalities)
HLA mapping
PSA (male patients)
PRA
EBV, VZV, HSV, toxoplasmosis (female patients)
Pelvic examination and Pap smear
Liver biopsy (viral hepatitis B / C, patients with transaminase abnormalities)
Chest X-ray
Gynecologic consultation, gynecologic related ultrasound (female patients)
Electrocardiogram
CYP 3A5 genotype (possible recipient of an immunosuppressive regimen containing tacrolimus)
Echocardiogram
Intracranial angiography (in patients with polycystic kidney)
PPD skin test
Non-invasive vascular examination (bilateral iliac vessels)
Ultrasound (hepatobiliary, splenic and pancreatic)
Upper gastrointestinal barium meal
Urological ultrasound (both kidneys, ureters, bladder)
Only after detailed examination and careful selection can we ensure the success rate and improve the quality of kidney transplantation.