Kidney Transplant Program

People with advanced chronic kidney disease and those on dialysis may be treated with a kidney transplant. A Mayo Clinic transplant team can evaluate you to determine whether a kidney transplant may be safe and beneficial for you.

Your comprehensive evaluation includes blood tests, imaging scans and other tests. Doctors check you for other serious conditions, including chronic infections, cancer, and heart and blood vessel disease, also called cardiovascular disease.

This may take several days or more. You do not have to be in the hospital for these appointments. After your tests and appointments, your transplant team reviews the results and talks about them with you. Then the team meets later to determine whether a kidney transplant may be a good option for you.

Most people who are evaluated are eligible for a kidney transplant. If you decide to have a transplant, your doctors and transplant team work with you to promote wellness, lower your risks and improve your results after kidney transplant. A care team member talks with you about the importance of taking medicines to keep your body from rejecting your new kidney. These medicines are called immunosuppressants or antirejection medicines.

A kidney transplant is a treatment for chronic kidney disease, also called chronic kidney failure. It is not a cure. Some kinds of kidney disease may come back after a transplant. The goal of a successful transplant is to help you feel better, live longer, be more active and enjoy life more.

Eligibility criteria

The specific eligibility criteria a person must meet to be considered for kidney transplant at Mayo Clinic include:

• Very low kidney function as measured by the glomerular filtration rate (GFR). To qualify, your GFR must be at or below approximately 20 milliliters per minute (mL/mm). If you have higher kidney function, a GFR of up to 25 mL/min, you may still qualify if:
  • Your condition is quickly getting worse, declining by a GFR of at least 10 mL/mm a year.
  • You are a candidate for a living-donor transplant.
• Receiving chronic dialysis for end-stage renal disease.

Exclusion criteria

Meeting the eligibility criteria does not necessarily mean you are a kidney transplant candidate. There also are specific exclusion criteria that must be addressed before a kidney transplant. Exclusion criteria include:

• Having cancer that is likely to get worse after a transplant.
• Having a severe infectious disease.
• Inability to safely tolerate immunosuppressant medicines.
• Not able to do the kidney transplant successfully for surgical reasons.
• Severe disease of the lung and heart, called cardiopulmonary disease.
• Severe pulmonary hypertension, which is very high blood pressure that affects the arteries in the lungs and the right side of the heart. Specialists measure blood pressure in the upper right chamber of your heart by millimeters of mercury (mm Hg). A right ventricle systolic pressure (RSVP) of more than 50 mm Hg is disqualifying for a kidney transplant.
• Long-term dependence on supplemental oxygen.
• Other health problems, called comorbidities, that would significantly reduce the benefit of transplant, including patient survival and continuing function of the implanted kidney.
• Life expectancy of less than five years, even with a successful kidney transplant.
• Extreme obesity, with a body mass index (BMI) of more than 45.
• Inability to comply with transplant-related management and follow-up medical care.
• No social support system to help with the transplant and recovery.
• Active risky use of drugs or alcohol.
• A severe mental health condition that is likely to interfere with post-transplantation treatments and care plans.
• Lack of insurance coverage or inability to cover the expenses involved with a transplant and the subsequent care.
• Deciding not to have the transplant.
• The condition affecting the kidneys isn't yet severe enough to require a transplant.