Evaluation before NTX (kidney transplantation)
Two-year waiting period for a patient to be readmitted to Eurotransplant
Advanced kidney disease (CKD), i.e. kidney failure, is treated with dialysis. These therapeutic procedures, so-called “Renal replacement therapy” can only be avoided with a kidney transplant.
This requires evaluations by different medical fields, which can be very painful (since it is not personalized!). Here is one of these Events (Based on facts!) explained:
History: 48-year-old patient (after 8 years of waiting) is transplanted. After only 6.5 weeks (super creatinine of 1.3 mg/dl, everything tip-top!), the kidney is explanted again (the kidney is removed!) due to an aneurysm at the entrance to the kidney, which was not detected by three ultrasounds during this time. During and after this, serious interventions with serious consequences follow.
Two years later (2022), the patient, who has now recovered from the consequences and is now 50 years old (10 years waiting time), tries again to get listed. The same university hospital with an annual workload of 150-300 kidney transplants where the explantation with serious consequences took place offers an evaluation interview in September 2022.
During this consultation, examinations (highly invasive) are requested that were not requested before the age of 50 (in this case, cardiological assessment using cardiac catheterization, HKU), because the patient previously did not mathematically fit into this category (preventive examinations from age 50). Although the family cardiologist has also confirmed that he has no concerns, it is demanded as an absolute: “No HKU, no listing“.
The patient has immense difficulty and concerns with the required HKU and asks for a cardio-CT, as his family cardiologist confirms no difference in the cardiological assessment now at the age of 48. However, this is not recognized by the transplant physicians at the university hospital. In the end, a listing is refused.
Patient changes university hospital on June 2023. Although many examinations have already been carried out, except for cardiac catheterization, the new transplant office of the other university hospital demands dozens of new examinations (here again examinations from the retirement savings catalog plus HKU), here even without suspicion from another doctor.
The patient starts again from the beginning, having all the tests carried out for the second time, some of which are required in this university hospital (in your own hospital!).
In these invasive examinations (here HKU, cardiac catheterization) there is no confirmation of the concerns of the TP doctor at the previous university hospital (just as the in-house cardiologist confirmed annually, here too 2 months ago), who requested this on the grounds that “you might not survive the operation!“.
In this case, the following problems arise in the evaluation before kidney transplantation:
Update 06.2024: Since the last examinations of a department of the previous university hospital are not passed on after three requests, the patient asks this department doctor for a statement as early as March 2024, resulting in a delay into September 2024, when the next six-monthly examination has been scheduled, where the patient must again apply for a statement.
Update 10.2024: Now the current university hospital transplant center is demanding an invasive procedure from the department of the previous university hospital, just to calculate the sign of onset of tumor formation.
Update 02.2025: Finally. Patient is listed!
Total duration of the evaluation procedure: September 2022 – February 2025 = 2 years and 4 months
Question to the DGfN (German Society for Nephrology): Is it just a communication problem within the university hospitals or is it a deliberate denial (making it more difficult and delaying) of a better therapy option due to a lack of organ donations?
(Picture is only to illustrate the problem of delay or difficulty) After 2 years, the list of examinations has not been fully carried out. Why?
Evaluation before NTX (kidney transplantation)
Two-year waiting period for a patient to be readmitted to Eurotransplant
Advanced kidney disease (CKD), i.e. kidney failure, is treated with dialysis. These therapeutic procedures, so-called “Renal replacement therapy” can only be avoided with a kidney transplant.
This requires evaluations by different medical fields, which can be very painful (since it is not personalized!). Here is one of these Events (Based on facts!) explained:
(Picture is only to illustrate the problem of delay or difficulty) After 2 years, the list of examinations has not been fully carried out. Why?
Prehistory: 48-year-old patient (after 8 years of waiting) is transplanted. After only 6.5 weeks (super creatinine of 1.3 mg/dl, everything tip-top!), the kidney is explanted again (the kidney is removed!) due to an aneurysm at the entrance to the kidney, which was not detected by three ultrasounds during this time. During and after this, serious interventions with serious consequences follow.
Two years later (2022), the patient, who has now recovered from the consequences and is now 50 years old (10 years waiting time), tries again to get listed. The same university hospital with an annual workload of 150-300 kidney transplants where the explantation with serious consequences took place offers an evaluation interview in September 2022.
During this consultation, tests are requested that were not required before the age of 50 (in this case, cardiological assessment using cardiac catheterization, HKU), because the patient previously did not mathematically fit into this category (preventive examinations from age 50). Although the family cardiologist has also confirmed that he has no concerns, it is demanded as an absolute: “No HKU, no listing“.
The patient has immense difficulty and concerns with the required HKU and asks for a cardio-CT, as his family cardiologist confirms no difference in the cardiological assessment now at the age of 48. However, this is not recognized by the transplant physicians at the university hospital. In the end, a listing is refused.
Patient changes university hospital on June 2023. Although many examinations have already been carried out, except for cardiac catheterization, the new transplant office of the other university hospital demands dozens of new examinations (here again examinations from the retirement savings catalog plus HKU), here even without suspicion from another doctor.
The patient starts again from the beginning, having all the tests carried out for the second time, some of which are required in this university hospital (in your own hospital!).
In these invasive examinations (here HKU, cardiac catheterization) there is no confirmation of the concerns of the TP doctor at the previous university hospital (just as the in-house cardiologist confirmed annually, here too 2 months ago), who requested this on the grounds that “you might not survive the operation!“.
In this case, the following problems arise in the evaluation before kidney transplantation:
Update 06.2024: Since the last examinations of a department of the previous university hospital are not passed on after three requests, the patient asks this department doctor for a statement as early as March 2024, resulting in a delay into September 2024, when the next six-monthly examination has been scheduled, where the patient must again apply for a statement.
Update 10.2024: Now the current university hospital transplant center is demanding an invasive procedure from the department of the previous university hospital, just to calculate the sign of onset of tumor formation.
Update 02.2025: Finally. Patient is listed!
Total duration of the evaluation procedure: September 2022 – February 2025 = 2 years and 4 months
Question to the DGfN (German Society for Nephrology): Is it just a communication problem within the university hospitals or is it a deliberate denial (making it more difficult and delaying) of a better therapy option due to a lack of organ donations?
Evaluation before NTX (kidney transplantation)
Two-year waiting period for a patient to be readmitted to Eurotransplant
Advanced kidney disease (CKD), i.e. kidney failure, is treated with dialysis. These therapeutic procedures, so-called “Renal replacement therapy” can only be avoided with a kidney transplant.
This requires evaluations by different medical fields, which can be very painful (since it is not personalized!). Here is one of these Events (Based on facts!) explained:
(Picture is only to illustrate the problem of delay or difficulty) After 2 years, the list of examinations has not been fully carried out. Why?
Prehistory: 48-year-old patient (after 8 years of waiting) is transplanted. After only 6.5 weeks (super creatinine of 1.3 mg/dl, everything tip-top!), the kidney is explanted again (the kidney is removed!) due to an aneurysm at the entrance to the kidney, which was not detected by three ultrasounds during this time. During and after this, serious interventions with serious consequences follow.
Two years later (2022), the patient, who has now recovered from the consequences and is now 50 years old (10 years waiting time), tries again to get listed. The same university hospital with an annual workload of 150-300 kidney transplants where the explantation with serious consequences took place offers an evaluation interview in September 2022.
During this consultation, tests are requested that were not required before the age of 50 (in this case, cardiological assessment using cardiac catheterization, HKU), because the patient previously did not mathematically fit into this category (preventive examinations from age 50). Although the family cardiologist has also confirmed that he has no concerns, it is demanded as an absolute: “No HKU, no listing“.
The patient has immense difficulty and concerns with the required HKU and asks for a cardio-CT, as his family cardiologist confirms no difference in the cardiological assessment now at the age of 48. However, this is not recognized by the transplant physicians at the university hospital. In the end, a listing is refused.
Patient changes university hospital on June 2023. Although many examinations have already been carried out, except for cardiac catheterization, the new transplant office of the other university hospital demands dozens of new examinations (here again examinations from the retirement savings catalog plus HKU), here even without suspicion from another doctor.
The patient starts again from the beginning, having all the tests carried out for the second time, some of which are required in this university hospital (in your own hospital!).
In these invasive examinations (here HKU, cardiac catheterization) there is no confirmation of the concerns of the TP doctor at the previous university hospital (just as the in-house cardiologist confirmed annually, here too 2 months ago), who requested this on the grounds that “you might not survive the operation!“.
In this case, the following problems arise in the evaluation before kidney transplantation:
Update 06.2024: Since the last examinations of a department of the previous university hospital are not passed on after three requests, the patient asks this department doctor for a statement as early as March 2024, resulting in a delay into September 2024, when the next six-monthly examination has been scheduled, where the patient must again apply for a statement.
Update 10.2024: Now the current university hospital transplant center is demanding an invasive procedure from the department of the previous university hospital, just to calculate the sign of onset of tumor formation.
Update 02.2025: Finally. Patient is listed!
Total duration of the evaluation procedure: September 2022 – February 2025 = 2 years and 4 months
Question to the DGfN (German Society for Nephrology): Is it just a communication problem within the university hospitals or is it a deliberate denial (making it more difficult and delaying) of a better therapy option due to a lack of organ donations?
