Kidney Transplant program
Frequently asked questions
How long will my patient wait for a kidney?
From the time a referral is received, the transplant assessment takes three to nine months for recipients with a living donor and six to 12 months for recipients without a living donor. The specific timeframe depends on the medical complexity of the patient or kidney donor, his or her availability to attend appointments, and completeness of the initial referral. For patients with a living donor not yet on dialysis, we try our best to complete the assessment to facilitate transplant pre-emptively before requiring dialysis.
If the recipient is approved for transplant, he or she may be added to the provincial wait list for a deceased donor kidney. Currently, the wait time in Ontario may be up to fve to nine years, depending on the patient’s blood type, antibody level, and availability of organs. Each patient’s position on the wait list is determined by allocation point which is calculated by:
Allocation score = 0.1 point per 30 days on dialysis + 4*(cPRA/100)
As patients gain allocation points, they move up on the wait list.
For recipients with a living donor, surgery is usually scheduled six to 12 weeks after both recipient and donor have been cleared.
What can I do to prepare my patient for kidney transplant?
An informed patient is key for good health outcomes after transplant. All transplant candidates attend a mandatory Learn about Transplant class at St. Michael’s as the first step in the work-up process. Patients and family members receive written information throughout the transplant process about different transplant options, what to expect after transplant, how to prepare beforehand, being on the wait list, and living donation. All of our patient education material is posted on our patient education website. We welcome you to use these resources to educate patients and their potential kidney donors.
If you’d like to increase your own transplant knowledge to better educate and inform patients, we encourage you to attend our next educational symposium for nephrology nurses and allied health professionals.
What transplant options and services are available for patients at St. Michael’s?
We offer a variety of options for adult CKD patients who are interested in pursuing kidney transplant:
- Wait-list for deceased donor transplant
- Living donor transplant
- Desensitization protocol for blood type (ABO) incompatible recipient-donor pairs using Glycosorb® technology (first in North America)
- National kidney paired donation program, commonly known as ‘paired exchange’ or ‘kidney chains’
- List exchange program
- Listing in national highly sensitized patient (HSP) registry for patients with difficult-to-match antibody levels (cPRA ≥95%)
- A shorter waiting time on the Extended Criteria Donor (ECD) list for eligible patients
Our multidisciplinary team provides a comprehensive suite of services for transplant candidates, recipients, and living donors, including:
- Transplant candidate assessment
- Living donor candidate assessment, including out-of-country donors when feasible
- Longitudinal multidisciplinary post-transplant follow-up care
- Patient health information website, print material, group and individual in-person classes
- Weight loss program for transplant candidates with BMI ≥40 kg/m2
- Opportunity to participate in clinical research trials
- Opportunity for patients and families to provide input via the Patient and Family Advisory Council
How long does a kidney transplant last?
Our graft survival rates are comparable to or exceed those seen in transplant centres across North America.
How do I find out the status of my patient’s transplant workup?
We will provide regular updates to let you know the status of each patient’s transplant workup. We will inform you:
- when we have received the referral
- when the patient has seen the transplant nephrologist
- when a decision has been made regarding the patient’s suitability for transplant
Throughout the process, we will let you know regarding the patient’s appointments with us. As well, we will contact you to request additional test results or reports if required. We also maintain regular contact with patients directly through mail or email to provide them the same updates.
In order to provide timely updates, it is important that we have the most current referral contact details. If a patient changes care team or there are staff changes, please inform us as early as possible by email at JayomaM@smh.ca (for patients without living donor) or GabrielM@smh.ca (for patients with a living donor).