Transplant Services

Click here to fill out a kidney candidate referral form. 

Click here to fill out the authorization form.

Kidneys perform critical functions for the human body such as:

• Removing waste products from the blood
• Balancing the nutrients and chemicals in the blood
• Regulating blood pressure
• Maintaining fluid
• Producing hormones that stimulate red blood cell production

Your kidneys are bean-shaped and weigh approximately 6 ounces. They are located behind the upper abdominal organs on either side of your spine.

If you have advanced kidney disease you could be a candidate for a kidney transplant. Additional requirements may be:

• Being on dialysis
• Kidney functions that are at or below 20%
• Type 1 Diabetes with Chronic Kidney Disease
• Acceptable lung function
• Acceptable cardiovascular, vascular and lung function
• BMI of <40
• And others

The kidney transplant process starts by talking to your doctor or nurse for a consultation about having a kidney transplant. Your doctor will refer you to Halifax Health – Center for Transplant Services. Our center will work with you and your dialysis social worker in completing the necessary forms.

• Evaluation Day: Consists of two medical evaluations with the Transplant Nephrologist and Transplant Surgeon, meetings with the Transplant Team and bloodwork
• Team Meetings and Patient Selection: Before the candidate's final, pre-transplant tissue-typing test, there will be a 'Patient Selection Committee' to discuss the readiness of the transplant based on the candidates' medical, financial and psychosocial information compiled during the evaluation process. They will decide if the candidate needs further medical or psychological assessment and if their financial and social support is adequate.

 How does a kidney transplant differ from dialysis? 

• With dialysis, one has a machine that acts as the kidney to filter your blood
• During dialysis, the blood is only filtered during treatments while a functioning kidney filters blood 24/7

Do I need a doctor referral or can I contact the transplant program myself?

• A doctor's referral isn't necessarily needed but your doctor may have test results and information that will make it easier for evaluation. But you are allowed to contact our transplant center on your own.

Can I be evaluated for a transplant before I need dialysis?

• Yes, knowing your glomerular filtration rate (GFR) is always needed and beneficial
• Your GFR needs to be 20 or below before evaluation
• The earlier the better to start the discussion about transplant options

Do I need medical insurance for a transplant evaluation?

• Due to the drugs and the follow-up medical care needed, even after the transplant surgery, insurance is usually encouraged. Our social worker can help you with insurance or other financial options.

Facts about early kidney transplant:

• Refer for transplant EARLY (minimum eGFR 25ml/min)
• Patients are eligible to start gaining waiting time when eGFR is 20ml/min or below
• Work up and approval for kidney transplant can take up to six months
• Early transplant allows for better surgical outcomes and quality of life
• Anyone can refer a patient for kidney transplant (any provider, health care professional or patients can self-refer)
• Referring to Halifax Health - Center for Transplant Services allows patients to remain in the community and receive this life saving gift (adult kidney transplants only)

Because of the time it takes to get kidney transplant qualified for waitlisting, it is best to consider referring the CKD patient for transplant when the eGFR is 25ml/min or below. It is possible for the transplant center to work up the patient and get them qualified for transplant listing and schedule monthly labs so that as soon as the eGFR meets the criteria for listing (20ml/min) the patient can be actively listed and start gaining wait time.

Early referral provides time for identification and evaluation of potential living kidney donors as well as improved patient education regarding transplant options.

If you haven't registered to be an organ donor yet, and would like to, click here to register.

What you might be thinking:
“My patient has not expressed an interest in transplant”:

According to OPTN (Organ Procurement and Transplantation Network), prior to transplant evaluation, many patients have no basis on which to have an opinion about transplant.  Expecting patient interest prior to learning about their options may not be a fair basis to decide on referral for evaluation. Keep in mind that for every other standard of care therapy, patient interest is not a requisite criterion. For example, a patient referred for a heart catheterization is not expected to have knowledge of catheterization risk and benefits and alternatives. Rather, it is expected that the patient will be educated once he sees the cardiologist. Similarly, in transplant compared to dialysis, interest in transplantation should be appropriately gauged after transplant education has been provided and should not be part of the decision to refer for kidney transplant evaluation.

What you might be thinking:
“Waiting to refer until the patient has stabilized on dialysis is better”

According to a 2019 retrospective study in France, preemptive kidney transplant was associated with LOWER risk of graft failure than kidney transplant performed AFTER the initiation of dialysis, regardless of the duration of dialysis.