Kidney Transplant Criteria

The UToledo Health transplant team developed the following criteria as a screening tool for determining potential transplant candidates. This is not all-inclusive and the final decision will be determined by the transplant surgeon.

Indications for kidney transplant

Patients with end-stage renal disease, defined by the United Network for Organ Sharing (UNOS) as a glomerular filtration rate (GFR) of < 20 mL/min.

Patients with progressive renal insufficiency as evidenced by deteriorating renal function. Patients with a GFR > 20 mL/min can be listed for a 0-antigen mismatch deceased donor kidney.

Other criteria

• UToledo Health has no strict age limit, though patients age 68 and older require a physician review before their referral can move forward.
• Targeted BMI is ≤ 40 for all deceased donor and living donor recipients. If BMI is > 40 with comorbid conditions, bariatric surgery in the form of least restrictive procedures will be recommended at the discretion of the surgeon in consultation with a registered dietitian.
• All patients require a psychosocial evaluation and clearance by a social worker, including a review of medical compliance. Documentation is essential.

Medical clearance

• Cardiac disease: requires cardiac clearance
• Diabetic patients over the age of 50: requires cardiac clearance
  Peripheral vascular disease: Requires CT of abdomen and pelvis and, if indicated, vascular evaluation and clearance
• Malignancy: The required no evidence of disease (NED) period varies by cancer type (e.g., melanoma, 5 years)
• Tobacco: Abstinence required for 60 days prior to listing; testing may be done to confirm
• Substance abuse: No alcohol abuse or illegal drug use; random testing may be done to confirm
• Obesity: Based on body habitus at the transplant surgeon’s discretion
• HIV: HIV positive patients must meet inclusion criteria as determined by the transplant surgeon
• TB or TB exposure: Requires infectious disease clearance
• Psychiatric history: Requires psychiatrist or clinical psychologist clearance

Financial Evaluation

Financial coverage of all patients is evaluated on an individual basis. Those patients deemed medically acceptable for organ transplantation by the University of Toledo Medical Center recipient transplant selection process may be provided the option of transplantation. 

Potential transplant candidates are not discriminated against based upon their financial situation. 

However, those individuals will be denied transplant who demonstrate a lack of cooperation by: 

• Not applying to prescription assistance programs when available.
• Not meeting out-of-pocket medical costs (prescriptions co-pays, insurance deductibles); and/or
• Not applying for and/or maintaining Medicaid/Medicare Parts A, B, and D.

See Policy 3364-100-50-21 – Financial Policy for Organ Transplant Recipients for more information. 

The Selection Committee will evaluate other medical/psychosocial/economic issues as it deems appropriate for successful long-term transplant outcomes.