Each end-stage renal disease patient is assigned a coordinator from the UCLA Kidney Transplant Program at the time of the initial evaluation. Transplant coordinators are nurses who will be responsible for the overall coordination of your child's transplant-related care at UCLA. They will maintain contact with the patient's referring doctor and/or local pediatrician.
At the time of the evaluation appointment, the UCLA kidney transplant office may request the following information:
Full chemistry panel
Complete blood count (CBC), differential, platelet count
Hepatitis studies
HIV screening
Blood test for syphilis (VDRL)
CMV titers, EBV titers
Evidence of up-to-date immunizations
Urine culture with sensitivities
Recent electrocardiogram (within 6 months)
Chest x-ray and/or PPD
Echocardiogram
Renal ultrasound, if necessary
Pediatric transplant candidates are evaluated at UCLA in two or three outpatient visits. The evaluation process includes a thorough medical and psychosocial assessment, and every effort in made to provide a relaxed, supportive and informative experience for patients and their families.
An evaluation appointment can be scheduled by calling the Transplant Office at UCLA Children's Hospital at (310) 206-6492. During the evaluation, appointments will be scheduled for you to meet with the transplant nephrologist, surgeon, transplant coordinator and social worker.
The nephrologist will perform a complete history and physical, review previous test results and decide if any further tests are required. The surgeon will discuss the transplant procedure and address any issues that may affect the surgery itself. Your child's UCLA transplant coordinator will communicate with his/her kidney doctor, keep records up-to-date, and be your contact person to answer questions. Information about the transplant evaluation, listing process and waiting time periods will be provided by the transplant coordinator, as well as the options of living donor or cadaveric transplant. An assessment of your child's emotional well-being, transportation, housing and financial resources will be made by the social worker with involvement by the financial counselor, if necessary.
Also during this appointment, blood for tissue typing will be drawn. All other tests, including blood tests, will be arranged according to your provider policy. Potential kidney donors are encouraged to attend this appointment for information and to initiate the donation process.
Tests and examinations that will be performed at UCLA include:
Transplant nephrology medical evaluation
Surgical evaluation
Psychiatric and/or social work evaluation
Blood typing
Tissue type identification and antibody screening
Tissue type identification, blood type identification, and crossmatch test of any potential donor
Following the evaluation appointment, each child's case is presented at the weekly meeting of the UCLA Kidney Transplant Selection Committee, which is made up of all members of the renal transplant team. At this time, a determination is made if any other tests are required to ensure your child's candidacy for transplant. Your coordinator at UCLA will notify you and your referring physician and/or nephrologist of the recommendation made by the transplant team. Upon completion of additional tests with satisfactory results, the child is placed on the transplant waiting list.
The Pediatric and Adult Kidney Transplant Programs at UCLA offer both living-related and cadaver donor transplantation. If a patient is accepted as a transplant candidate at UCLA, the possibility of a living-donor transplant is explored and encouraged. With a living donor, a transplant can take place as soon as all tests are completed for the donor and recipient.
Children who require cadaveric transplantation are placed on the national transplant waiting list. Children who are less than 18 years old are given special consideration, to help achieve earlier transplantation. This list has over 40,000 potential recipients on it and is maintained by the United Network for Organ Sharing (UNOS). When a kidney is available, the donor blood type and tissue type are entered into the UNOS computer. Once the best possible match is identified, the UCLA Transplant Center is notified. The average wait for potential transplant recipients who live in the Los Angeles area is one to three years.
While on the waiting list, each patient's health status is followed closely. A monthly blood sample is sent by the dialysis unit and is held at UCLA to be tested with all potential donor kidneys. Close contact between your child's nephrologist, dialysis unit and UCLA coordinator is essential. Any hospitalizations, surgeries, tests, blood transfusions, infections or change in address and phone number should be related to your UCLA coordinator so records are up-to-date if a kidney becomes available. Each patient needs to schedule an appointment at UCLA every six months while on the waiting list.
