Assessment of transplant donors and candidates, and anticipating RRT
When to start planning for kidney failure, how a transplant candidate is worked up and which findings stop or delay listing, how to read a living donor's GFR, albuminuria and BP against KDIGO thresholds, and the immunological results that decide compatibility.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Planning for kidney failure starts a year or more ahead. Transplant is the best option for survival and quality of life in suitable patients, and a pre-emptive living donor transplant is better still.
- In Australia, only patients on dialysis can join the deceased-donor list (very rare exceptions), and waiting time counts from the start of long-term dialysis. Since 2018 TSANZ requires a high likelihood of significant benefit from transplant, judged by the unit's multidisciplinary team; the old 80% 5-year survival rule now applies only in New Zealand. Kidney allocation is under review (TSANZ "KOALA 2027"), so recheck these rules in 2027.
- Candidate assessment asks three questions: will they survive the operation, will they do well on immunosuppression, and are they immunologically compatible with a donor?
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Sources
- Chadban SJ et al. KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation. Transplantation 2020;104(4S1):S11-S103Kidney Disease Improving Global Outcomes, 2020 (current; no update listed, checked November 2026)
- Lentine KL et al. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation 2017;101(8S Suppl 1):S1-S109Kidney Disease Improving Global Outcomes, 2017 (current; no update listed, checked November 2026)
- Clinical Guidelines for Organ Transplantation from Deceased Donors, version 1.18AU/NZTransplantation Society of Australia and New Zealand, 1.18 (current, checked November 2026)
- Guidelines for Imlifidase Supported Kidney Transplantation in Australia, version 1.0AU/NZTransplantation Society of Australia and New Zealand, February 2026
- KHA-CARI Recipient Assessment for TransplantationAU/NZKHA-CARI, 2013
- KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney DiseaseKidney Disease Improving Global Outcomes, 2024
- Bateman S et al. The survival benefit of deceased donor kidney transplantation for Aboriginal and Torres Strait Islander people, 2006-20: a retrospective national cohort study. Med J Aust 2024;221(2):111-6AU/NZMedical Journal of Australia, 2024
- ANZDATA Registry 48th Annual Report 2025: summary of data to 31 December 2024 (transplant operations and living donor tables)AU/NZAustralia and New Zealand Dialysis and Transplant Registry, 2025
- Muzaale AD et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014;311:579-86JAMA, 2014
- Garg AX et al. Gestational hypertension and preeclampsia in living kidney donors. N Engl J Med 2015;372:124-33New England Journal of Medicine, 2015
- Bangalore S et al. Management of coronary disease in patients with advanced kidney disease (ISCHEMIA-CKD). N Engl J Med 2020;382:1608-18New England Journal of Medicine, 2020
- Ethical guidelines for cell, tissue and organ donation and transplantation in AustraliaAU/NZNational Health and Medical Research Council
- Last updated
- 14 November 2026
What changed
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