When is the best time to refer a patient to the transplant center?
The strategy for referral to the transplant center should be aimed at optimizing a patient’s chance at receiving a preemptive transplant. Patients with chronic kidney disease whose GFR is 25ml/min or less are eligible to be listed with UNOS for an HLA zero-mismatched deceased donor. GFR must however be 20 ml/min or lower to begin to accrue time on the general waitlist. Preemptive transplants in patients who have living donors are usually performed at a GFR of 15ml/min. Based on the progression of a patient’s disease, we recommend referral to the transplant center for patients whose GFR is expected to be 25ml/min or less within the next six months.
