Kidney Transplant Care
Expert Support Through Every Phase

For patients with end-stage kidney disease (ESRD), kidney transplant offers dramatically superior outcomes compared to dialysis — including a 2–3x improvement in long-term survival, significantly better quality of life, and freedom from dialysis sessions. A successful transplant allows most patients to return to nearly normal lives, resume work and travel, and enjoy a level of health that dialysis simply cannot replicate.

Despite these advantages, many patients with ESRD either are not evaluated for transplant or are referred too late — missing the opportunity for pre-emptive transplant (receiving a kidney before needing dialysis at all) or accumulating medical conditions that eventually render them ineligible. At AKSNB, we believe early identification and timely referral for transplant evaluation is one of the most important services we can offer our patients.

We begin discussing transplant as a treatment option when our patients reach Stage 4 CKD, initiating the evaluation process well before they reach ESRD. This proactive approach maximizes the chance of successful transplant and minimizes time spent on dialysis.

The pre-transplant evaluation is a comprehensive medical assessment that determines a patient's eligibility for transplant and optimizes their health prior to surgery. It involves evaluation by multiple specialists including nephrologists, transplant surgeons, cardiologists, and social workers.

At AKSNB, we initiate and coordinate the transplant evaluation process, managing the necessary cardiac, vascular, and infectious disease workups and serving as the primary nephrology interface with transplant centers. We work closely with major regional transplant programs — including those at UCSF, Stanford, and UC Davis — to streamline the evaluation and listing process for our patients.

We also help patients understand the difference between deceased donor and living donor transplantation, explain the waitlisting process, and discuss paired kidney exchange programs for patients with willing but incompatible living donors.

Receiving a kidney transplant is the beginning of a lifelong commitment to protecting that graft. Post-transplant nephrology care is specialized and demanding — immunosuppression management alone requires expert knowledge of calcineurin inhibitors, mycophenolate, mTOR inhibitors, and their complex drug interactions, side effects, and dosing requirements.

Our nephrologists provide dedicated post-transplant follow-up for patients who received their transplant at regional centers and return to our area for ongoing care. We monitor for acute and chronic rejection using protocol biopsies and clinical assessments, manage immunosuppression adjustments, treat post-transplant complications (including infections, malignancy risk, post-transplant diabetes, and hypertension), and coordinate with the transplant center for complex issues.

Our ultimate goal is simple: to help every transplant recipient keep their gift of a kidney for as long as possible. We take this responsibility seriously, and we provide the meticulous, knowledgeable follow-up care that gives transplanted kidneys the best chance of long-term success.