Kidney Transplant Selection Criteria

What: Selection criteria are the requirements your transplant team uses to decide if a transplant is the best and safest option for someone with end stage renal disease.

Selection Criteria:

Indications:

• Patient has end-stage renal disease (ESRD) as evidenced by measured (actual urinary collection) creatinine clearance level or calculated GFR (Cockcroft-Gault or other reliable formula) less than or equal to 20ml/min or initiation of dialysis.

Relative Contraindications: 

• Age ≥ 75  
• Morbid obesity (BMI ≥ 35)  
• Inadequate bladder/urinary conduit
• Frailty
• Multiple medical comorbidities
• History of Malignancy or active malignancy  
• Psycho-Social issues
• Oxalosis (may require liver/kidney transplantation)
• Cirrhosis 

Absolute Contraindications: 

• Morbid obesity (BMI ≥ 45)
• Active systemic infection
• Active substance abuse  
• Sickle cell disease  
• Significant psychiatric illness likely to interfere with adherence
• HIV – CD4 count < 200 or detectable viral load
• Severe cardiac disease
• Severe peripheral vascular disease/Vascular calcifications
• Active Malignancy, see AST recommendations for wait intervals
• Hepatitis B infection (detectable viral load)
• Decompensated cirrhosis
• Medical non-adherence
• Active wounds
• COPD/Oxygen dependence
• Pulmonary Hypertension PAS ≥ 70
• Inadequate insurance