Once the patient has received education, the patient is referred to the local transplant clinic or kidney care clinic. Screening is done as part of the referral process to the provincial transplant centre (Vancouver General Hospital and St. Paul's Hospital). Some of this screening includes information about previous blood transfusions, prior pregnancies, prior transplants, and kidney biopsies

Patient Resources:

• Step 2: I would like to start the testing for kidney transplant
  

Testing includes blood tests such as those that are standard during regular health checks and more specifically those to rule out sexually transmitted infections (STIs), diagnostic tests such as chest x-ray, cardiac testing and various other tests such as tuberculosis, fecal test for colon cancer screening, etc. Some tests will take more time than others, but it is an important step towards ensuring your patient is suitable to receive a living donor kidney transplant.

The local transplant clinic and kidney care clinic work together to ensure that all the testing required is completed and sent to Vancouver General Hospital or St. Paul's Hospital.  The patient's family doctor may be contacted to provide important health information as well.

Once testing is complete and the referral is sent to Vancouver General Hospital or St. Paul's Hospital, the priority in which the patient will be seen and assessed depends on different factors. For example, your patient will be assessed more quickly if they have identified a living donor and the living donor has registered as a possible donor. People with registered living donors are prioritized over those who do not have a living donor registered.  People with lower GFR may get prioritized to be seen sooner as well.

It is important to continue to have living donor outreach discussions with your patient and addressing any challenges that may come up along the way.

Living Donor Resources:

• Living Donor Outreach Staff resource package
• Staff Guide: Facilitating Donor Outreach Conversations with Patients
• Conversations with Patients About Donor Outreach
• Tips on how to help a patient through the living donor outreach process
  

Vancouver General Hospital or St. Paul's Hospital will review testing results that were completed at the local clinic.  The results will help them decide whether your patient is suitable to proceed with the next step on the journey towards living donor kidney transplant. 

• If the transplant team decides your patient is suitable to proceed, they will start the assessment process. This may include more testing and a visit will be scheduled with the transplant team
• If they decide your patient cannot proceed, they will be contacted by their nephrologist or kidney care team. The team will explain to the patient the reasons why and discuss other treatment options
  

Vancouver General Hospital or St. Paul's Hospital will schedule an assessment visit with your patient to help determine whether they are suitable for transplant based on all of the testing that was completed. The initial assessment is done by the transplant surgeon (urologist), transplant physician (nephrologist) and transplant nurse and/or social worker. More tests may be requested based on the assessment with the transplant team.

It is important to continue to have living donor outreach discussions with your patient and addressing any challenges that may come up along the way.

Patient Resources:

• Step 5: I have been referred to Vancouver General Hospital or St. Paul's Hospital for assessment

• Living Donor Outreach Staff resource package
• Staff Guide: Facilitating Donor Outreach Conversations with Patients
• Conversations with Patients About Donor Outreach
  
• Tips on how to help a patient through the living donor outreach process
  

The transplant team will determine if your patient is suitable for a living donor kidney transplant once you have been assessed.  To help determine whether they are suitable, there may be some more testing that is required depending on your patient's individual circumstances. 

• If your patient is not suitable, the transplant team will contact them and provide the reasons why they are not able to proceed. 
• If your patient is suitable, the next step is to start preparing them for the transplant procedure.

The provincial transplant donor team will communicate with the recipient's transplant team to determine the timing of the transplant procedure based on their level of kidney function and whether a donor will be ready.

It is important to continue to have living donor outreach discussions with your patient and addressing any challenges that may come up along the way.

Patient Resources:

• Step 6: I am done with testing and the transplant team has said I am approved for kidney transplant

• Living Donor Outreach Staff resource package
• Staff Guide: Facilitating Donor Outreach Conversations with Patients
  
• Conversations with Patients About Donor Outreach
  
• Tips on how to help a patient through the living donor outreach process