The process of finding a suitable transplant kidney is very complex and even a well matched person may still not be a suitable recipient. After the United Network of Organ Sharing (UNOS) has identified you to be a potential match for a kidney and before you are notified, your Kidney Transplant Procurement Coordinator will contact your Kidney Transplant Surgeon who determines if the kidney is indeed suitable for you. Many wonder about the criteria which the surgeon uses. The answer is complicated and is explored below.
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Most people are aware of the obvious reasons why a Kidney Transplant Surgeon would not conduct a transplant operation on a patient such as if s/he had an infection, was significantly over weight, or suffered some other clear medical problem(s) that could complicate the procedure and recovery. But many do not know that a surgeon's decision to conduct a Kidney Transplant operation comes down to clinical judgment, utilizing actual observation combined with clinical experience in deciding whether or not to intervene. The fact is that every person with CKD is different and every kidney transplant surgeon has his/her own experiences and disposition so one surgeon may choose to operate on a person where as another may opt out of the procedure given the same circumstances.
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Since clinical judgment differs to a major degree from one surgeon to the next, you as a patient should understand the philosophy of your surgeon and the transplant program that you enlist. Some programs and surgeons are very aggressive and believe that if they have the opportunity to safely transplant they will. On the other hand, some programs, and in turn surgeons, are extremely cautious and do not transplant unless circumstances are perfect to do so. While most Transplant Centers and teams are somewhere along a continuum. What kind of CKD patient are you? This is important because you should identify a program that is not just the most convenient but one that has a Transplant Team of people who share your "transplantation goals and values."
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Your Transplant Coordinator will be available by telephone to answer any questions that you may have every step of the way. KidneyBuzz.com suggests some questions to consider asking your coordinator or surgeon directly:
- What kind of training/educational background does the Surgeon have?
- How long has this Hospital and Surgeon been conducting Kidney Transplants?
- What are the kidney and patient survival rates for this Hospital and Surgeon and how does that compare to others?
- What is the Hospital's and Surgeon's clinical judgment philosophy?
After you have asked and received acceptable responses to your questions, you should feel comfortable about proceeding since you will be convinced that your objectives match the Hospital and surgeon's clinical judgment.
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"Crozer-Chester Medical Center." Important Questions to Ask
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"Surgical Decision Making: The Reliability of Clinical Judgment." US National Library of Medicine National Institutes of Health Search Term Search Database Clear Input.
"Defining High Risk in Adult Kidney Transplantation." "Surgical Decision Making: The Reliability of Clinical Judgment." US National Library of Medicine National Institutes of Health Search Term Search Database Clear Input.
"Staff Interview." United Network of Organ Sharing (UNOS).