Kidney-Alone Referrals

Patients with or nearing End Stage Renal disease may be considered for renal transplantation. Carolinas Medical Center does not have an absolute age criteria. All patients are reviewed on an individual basis to provide fair and non-discriminatory consideration.

However, the following are contraindications to renal transplant:

  • Untreated and/or active malignancy
  • Chronic and/or active infection
  • Untreated and/or active cardiac ischemia
  • Advanced heart failure (unless candidate for combined heart/kidney transplant)
  • Advanced liver disease (unless candidate for combined liver/kidney transplant)
  • Advanced cerebrovascular or neuro-degenerative disease
  • Severe chronic lung disease
  • Active collagen vascular disease
  • Uncorrected urologic disease
  • Morbid obesity
  • Severe malnutrition
  • Ongoing non-adherence to medication and treatment regime
  • Active substance abuse
  • Marked deconditioning
  • Severe peripheral vascular disease
  • Social instability, in particular, poor family support and limited resources to maintain ongoing follow-up
  • Patient not interested or refusal

Kidney-Pancreas Referrals

Patients with or nearing End Stage Renal disease secondary to Type 1 Diabetes Mellitus may be considered for kidney/pancreas transplantation. All patients are reviewed on an individual basis to provide fair and non-discriminatory consideration. There are no absolute age criteria.

Patients with Type 2 Diabetes Mellitus will be considered for kidney/pancreas transplantation with the following guidelines:

  • BMI < 25
  • < 1.0 units insulin/kg/24 hours
  • Age < 50 years old
  • Must be a candidate for Steroid Avoidance Protocol to prevent exacerbation of insulin resistance.
  • Must have evidence of secondary microvascular complications

The following are contraindications for combined kidney/pancreas transplantation:

  • Untreated and/or active malignancy
  • Chronic and/or active infection
  • Untreated and/or active cardiac ischemia
  • Advanced heart failure
  • Advanced liver disease
  • Advanced cerebrovascular or neuro-degenerative disease
  • Severe chronic lung disease
  • Active collagen vascular disease
  • Uncorrected urologic disease
  • Morbid obesity
  • Severe malnutrition
  • Ongoing non-adherence to medications or treatment regime
  • Active substance abuse
  • Marked de-conditioning
  • Social instability, in particular poor family support and limited resources to maintain ongoing follow up
  • Patient refusal
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