Evaluation of the candidate patient for kidney transplantation

Abstract

Kidney transplantation is the best treatment available for patients with end-stage renal disease (ESRD). Compared to dialysis, transplantation improves quality of life and reduces the mortality risk for most patients. However, the decision on which modality of renal replacement therapy is the best for an individual should be carefully assessed as some patients would not be expected to benefit from transplantation. Patients with ESRD often have significant comorbidities, and the determination of suitability for kidney transplantation in such patients requires a multidisciplinary approach with input from specialists in a variety of medical and surgical disciplines along with allied health professionals. Evaluation of kidney transplant candidates includes an initial assessment to detect unrecognized absolute and relative contraindications to transplantation and a further tailored workup directed according to patient-specific conditions and comorbidities. In this review article, we suggest the optimal timing for a patient to be referred to a transplantation program and provide the assessment for transplant suitability with reference to available evidence and guidelines.