Transplant Digest Fall 2018/Winter 2019, Issue No. 25
Importance of the Pre Transplant Assessment Dr. Ramesh Prasad Every patient with chronic kidney disease being considered for a kidney transplant needs to have a pre-transplant assessment. If you are considering a transplant, then you will need to be seen by a nephrologist, surgeon (typically a urologist) and anesthesiologist. This whole process can be long and frustrating. It may take a few months to get these appointments. The appointments have to be scheduled around dialysis and other commitments, and sometimes even are on separate days. But why are these clinic appointments so important? The first purpose of the pre-transplant assessment is to make sure that you are an appropriate candidate both medically and surgically. It is critical to determine if the transplant will not cause you more harm than good. Conditions like cancer, severe heart disease, and chronic infections can become much worse after a transplant. The physical examination you undergo in the clinic and a review of all your test results up to that point are very important. It is also important to make sure that you are likely to take proper care of your transplant. The second reason is to provide education. The more you and your loved ones know about the transplant process, the more likely the transplant is going to be successful. A lot of information is shared, and you can bring as many people as you like to the appointment. The more people are engaged in the process, the better! The middle of the night, when you are called in for the transplant, is not the time to begin the education process.
In this issue... Importance of the Pre-Transplant Assessment From the Editor’s Desk Contact Information Chronic Antibody-Mediated Rejection Pneumocystic jirovecii Pneumonia The Molecular Revolution in the Microbiology Laboratory Cardiac Magnetic Resonance Imaging Study Completed! Post-Transplant Chat: Exercise Summer Experience at St. Michael’s Hospital Transplant Clinic International Transplant Nurse Society Conference in Germany Helping you stick to your medicines: a new pilot program at the clinic
The third reason is to outline specific risks and benefits of the transplant in your case. A particular medication strategy, or additional tests, may be required to make sure you can go on the list. Please consider the transplant listing as a “work in progress”, something to aspire towards, rather than just a simple “yes” or “no” on the appointment day. The next reason for the assessment is to improve your health. There are perhaps no other assessments in medicine that are so thorough. Sometimes new medical Continued on page 9
Transplant Digest Fall 2018/Winter 2019, Issue No.125