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Referral and Evaluation

Step 1 - Referral for a Kidney Transplant

There are 3 phases of your journey through kidney transplant. They are:

  1. Referral and Evaluation
  2. Wait List
  3. Post-Kidney Transplant

In this section, you will find information about the steps that happen during the Referral and Evaluation Phase. This guide is not all-inclusive, but will give you an idea of what lies ahead. The pre-transplant kidney nurse coordinator can answer your additional questions.

Referrals for kidney transplant can come from many sources including your nephrologist, your dialysis unit or yourself. Once you have expressed an interest in learning more about kidney transplant, your nephrologist or dialysis unit will fax us an Initial Referral Form.

Once the transplant program receives this referral, we will send a release of information to you to be signed and returned to us as soon as possible. The quicker you return it, the quicker we can get an appointment scheduled. We will request medical records from your nephrologist, dialysis unit and any other physician who has seen you.

Once we have received all medical and insurance information, an appointment for an evaluation will be scheduled. The pre-transplant kidney nurse coordinator will call you to do a brief phone interview before your appointment.

Step 2 - The Kidney Transplant Evaluation

Evaluations take place at the transplant clinic in Sioux Falls or one of several outreach clinics. We will work with you to find the most convenient time and place for your evaluation. Evaluation day starts promptly at 8:00 A.M. and goes until late that afternoon. Plan on an entire day at the clinic for your kidney evaluation. There will be a break for lunch.

What to expect during your evaluation

  1. Transplant Coordinator: provide you with initial education and answer your questions.
  2. Dietician: assess current dietary habits and compliance and explain possible diet changes after transplant.
  3. Diabetic Educator: if you have diabetes, a diabetic educator will visit with you and review your diabetic history, current medications and compliance. Potential changes in diabetes after transplant will also be discussed.
  4. Social Worker: assess your support system and explain the financial impact of transplant. If needed, your social worker will help locate resources needed for your transplant.
  5. Transplant Surgeon: assess your physical condition to make sure transplant surgery is safe for you. He will review the risks and benefits of surgery with you.
  6. Transplant Nephrologist: assess your overall physical condition to make sure there are no other medical conditions that would interfere with transplant.

You may also need to have a chest X-ray, EKG and lab work done during your evaluation.

Step 3 - Transplant Review & Selection Committee

Following your evaluation visit, your results will be presented to all transplant team members. At that time, recommendations will be made about additional tests that may be needed. Individuals who come to their evaluation with all their basic health care* updated will be able to be listed sooner. (*for details on basic health care needs, see “Your Health Maintenance Flowsheet” at the end of this section.)

Preventative screenings for cancer and infection are important to do prior to transplant because the immunosuppressant medications taken after transplant can make treating existing cancer or infection difficult.

Step 4 - Complete Recommendations

You will receive a letter from the program that identifies additional testing or evaluations by other specialist needed to complete your transplant evaluation. A copy of this letter will be sent to your nephrologist, your primary care physician and your dialysis unit. Your primary care provider or nephrologist can help you schedule these appointments.

To make sure your evaluation continues to move forward quickly, please schedule these recommended appointments as soon as possible. Make sure you have the results of these tests sent to the Avera Transplant Institute.

Step 5 - Review of Results & Listing

The team will review all your test results and decide if you are a candidate for kidney transplant. You will receive a letter explaining the decision. A copy of this letter will be sent to your nephrologist and your dialysis unit.

Donate Life America

In celebration of National Donate Life Month, Donate Life America (DLA) launches a new national Web site,, focusing on providing quick and easy access to state donor registries. The site features a new interactive map of the United States that links directly to state donor registration pages.

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News & Awards

We are proud of the local and national recognition our transplant programs receive. Here you can learn about the latest Avera Transplant Institute news, accreditations and awards.

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