Lesson 1Psychosocial and adherence assessment: evaluation of social support, substance use, medication adherence predictorsCovers structured psychosocial evaluation before transplant, including social support, mental health, substance use, and predictors of medication adherence, to identify barriers and design interventions that improve long-term graft survival.
Standardized psychosocial screening toolsEvaluating caregiver and social supportScreening for depression and anxietySubstance use history and toxicology testsPredictors and remediation of nonadherenceLesson 2Comprehensive medical history and physical exam: diabetes, cardiovascular, peripheral vascular disease, dialysis access reviewSummarizes the structure of a comprehensive pre-transplant history and physical exam, emphasizing cardiovascular, peripheral vascular, diabetes, and dialysis access review to identify contraindications and modifiable perioperative risks.
Structured transplant‑focused historyCardiovascular and peripheral vascular reviewDiabetes complications and foot examinationDialysis access function and infection historyMedication reconciliation and allergy reviewLesson 3Hematology and coagulation: platelet function, anticoagulation/antiplatelet management, transfusion thresholdsFocuses on hematologic and coagulation assessment, including anemia, platelet function, and management of anticoagulant and antiplatelet agents, to define transfusion thresholds and minimize bleeding and thrombotic events around surgery.
Baseline CBC, iron studies, and anemia planPlatelet count, function, and uremic bleedingWarfarin, DOAC, and heparin bridgingAntiplatelet interruption and continuationRed cell and platelet transfusion thresholdsLesson 4Vascular surgery assessment: peripheral arterial disease mapping, iliac/femoral vessel duplex/CT angiography, access site planningExplores vascular surgery assessment in kidney transplant planning, including mapping peripheral arterial disease, imaging iliac and femoral vessels, and selecting optimal access sites to ensure safe anastomosis and long-term graft perfusion.
Clinical exam for peripheral arterial diseaseDuplex ultrasound of iliac and femoral vesselsCT angiography for complex vasculatureChoosing side and site for graft anastomosisManaging severe aortoiliac occlusive diseaseLesson 5Pulmonary evaluation and anesthesia risk: spirometry, sleep apnea screening, frailty and functional status assessmentDescribes pulmonary and anesthesia risk evaluation, including spirometry, sleep apnea screening, frailty, and functional status, to estimate perioperative risk and guide optimization, monitoring, and postoperative disposition planning.
History, exam, and spirometry indicationsChest imaging and pulmonary hypertensionScreening and management of sleep apneaFrailty indices and gait speed testingAnesthesia risk classification and planningLesson 6Infectious disease evaluation: latent infections (TB, CMV, EBV, VZV, HBV, HCV, HIV), vaccination review, prophylaxis planningDetails infectious disease evaluation in transplant candidates, emphasizing latent infections, vaccination status, and individualized prophylaxis plans to minimize post-transplant opportunistic infections and reactivation under immunosuppression.
Screening for TB, CMV, EBV, and VZVHBV, HCV, and HIV testing and stagingPre‑transplant vaccination catch‑up planDonor‑recipient serostatus risk matchingDesigning antiviral and PCP prophylaxisLesson 7Cardiology workup: noninvasive ischemia testing, coronary angiography indications, functional capacity assessment, perioperative revascularization criteriaCovers cardiology workup for transplant candidates, including noninvasive ischemia testing, indications for coronary angiography, assessment of functional capacity, and criteria for revascularization to reduce perioperative cardiac events.
Baseline ECG and echocardiographyStress testing and ischemia detectionIndications for coronary angiographyFunctional capacity and METs assessmentRevascularization versus medical therapyLesson 8Endocrine and metabolic optimization: diabetes control strategies pre-transplant, obesity and nutritional optimization, weight-loss options and timelineReviews endocrine and metabolic issues before kidney transplant, focusing on diabetes optimization, obesity and nutrition, weight-loss strategies, and realistic timelines to reach metabolic targets that reduce perioperative and long-term complications.
Pre‑transplant HbA1c and glycemic targetsAdjusting insulin and non‑insulin therapiesObesity‑related surgical and graft risksNutritional assessment and protein‑energy statusPharmacologic and surgical weight‑loss optionsLesson 9Laboratory and imaging baseline tests: crossmatch/serology, HLA typing, PRA, baseline renal ultrasound and vascular imaging, baseline BK/JC viral statusOutlines essential laboratory and imaging tests that define the pre-transplant baseline, including HLA typing, PRA, crossmatch, serologies, renal ultrasound, vascular imaging, and BK/JC viral status to guide donor selection and perioperative planning.
ABO typing, HLA typing, and PRA levelsComplement‑dependent and flow crossmatchBaseline renal ultrasound and DopplerCT or MR angiography of iliac vesselsBK and JC virus PCR and serologic statusLesson 10Decision criteria to accept or delay transplant: cardiopulmonary thresholds, infection control, vascular access/target vessel suitability, BMI and metabolic targetsExplains how multidisciplinary teams decide whether to proceed with or delay kidney transplant, integrating cardiopulmonary thresholds, infection control, vascular suitability, and BMI and metabolic goals to balance urgency against modifiable risk.
Cardiopulmonary fitness and VO2 thresholdsActive infection and sepsis exclusionTarget vessel imaging and suitabilityBMI cutoffs and weight‑loss milestonesMetabolic syndrome and blood pressure goals
