Advancing research. Improving outcomes.
At UNC Medical Center, our kidney transplant outcomes consistently top national averages. To date, UNC surgeons have performed kidney transplants on more than 1250 adults and 150 children from around the country.
UNC surgeons performed the first laparoscopic-assisted live-donor kidney removal procedure in North Carolina, which reduces recovery time, scarring, and post-operative pain for altruistic kidney donors. Today, nearly all live-donor procedures at UNC are performed using this least-invasive procedure.
Candidacy for Kidney Transplant
At UNC, our goal is to evaluate potential transplant patients as early as possible in the course of their illness. Early evaluation not only allows us more time to locate a potential donor, including the possibility of finding a compatible living donor; it also helps reduce the possibility of further complications that may weigh against successful transplant.
Potential kidney transplant patients should be referred when their estimated glomeruler filtration rate (eGFR) is nearing 20-30 ml/min. This allows us adequate time to complete the evaluation before the need for dialysis. Early referral also allows patients without a living donor option to begin to accrue waiting time, which can start at an eGFR of 20 ml/min.
Transplant evaluations at UNC are scheduled so patients on dialysis will not have a conflict with routine dialysis schedules.
Every patient at UNC is treated as an individual, so we have a very limited list of absolute contraindications to kidney and kidney-pancreas transplantation. At present, those contraindications are:
- Children weighing less than 10 Kg
- Active infection
- Active substance abuse
- Active malignancy or malignancy with a high risk of recurrence (cancer-free time intervals may be required after treatment and are type- and stage-specific)
- Advanced coronary disease without options for interventional or surgical improvement (unless a candidate for cardiac transplantation)
- Advanced lung disease (unless a candidate for combined lung/kidney transplant)
- Neurologic deficits or psychiatric illness that prevent adherence to transplant medications and follow-up regimens
- Inadequate family or social support
- Medical non-compliance without a commitment to changing behavior
Issues such as age and obesity have historically been assigned cut-off values for transplantation. For obese patients with a body mass index (BMI) between 35 and 40, however, we can offer individualized, comprehensive weight reduction and health improvement plans to help improve the likelihood of transplant consideration.
To ensure compliance with specific health criteria necessary for transplantation, clinicians at the UNC Center for Transplant Care’s pre-transplant clinic closely monitor candidates with coordinated care from the referring physician.
Referral information should include the following:
- Patient demographics
- Insurance information
- A patient history and recent physical, including the cause of renal failure
- Dialysis start date and modality
- A summary of the most recent hospital discharge
- A current chest x-ray
- Electrocardiogram and laboratory values
- A summary of any consultations obtained within the last 12 months
If your patient has a history of substance abuse, we require documented abstinence, and counseling with a certified abuse counselor. Patients with an active substance abuse problem must first undergo counseling with a certified abuse counselor, then provide documentation of abstinence.
Making an Outpatient Referral
To make an appointment for an evaluation, or to ask questions about individual patients, call toll-free 844-862-5436 (844-UNC-KIDN). To refer a patient by fax, dial 984-974-0888.
Kidney/Pancreas Transplant Review and Referral Form
This form will streamline the process of referral for you, as well as give us important information with which to start evaluation for your patient.
Making an Inpatient Referral
To make an inpatient referral, please call the Transfer Center at 1-800-806-1968.
You may also reach a kidney transplant staff member using the information below:
Sarah H. Arldt , RN, BSN, Transplant Nurse Coordinator
Phone: (984) 974-7541
Fax: (984) 974-0888
Sandy Lynch, RN, MSN, CCRN, CCM, Transplant Nurse Coordinator, Pre-waitlist/New Evaluation Management
Phone: (984) 974-7544
Fax: (984) 974-0888
Megan Zink, BSN, RN, Transplant Coordinator
Phone: (984) 974-7569
Fax: (984) 974-0888