Your Transplant Journey.
Every Step Documented.
For patients on dialysis and on the UNOS transplant waitlist — this guide covers everything: how the waitlist works, finding a living donor, clearing medical requirements, what happens after, and how to reclaim a life without being tied to a dialysis schedule.
Understanding
the UNOS Waitlist
The United Network for Organ Sharing (UNOS) manages the national organ transplant system. Understanding how the waitlist works — and what you can do to improve your position — is critical. You are not just waiting passively. There are active steps that affect your timeline.
Why a Living Donor
Is the Better Path
A kidney from a living donor typically outlasts a deceased donor kidney by 5–10 years, the surgery can be scheduled on your timeline, and you can reduce your wait from years to months or even weeks. Living donors can be anyone — family, friends, coworkers, community members. They do not have to be a blood relative.
TGH Transplant: 813-844-7000
Email: contact@care.tgh.org
Pre-Transplant
Evaluation Checklist
Before a transplant center will place you on the active waitlist, you must complete a comprehensive medical evaluation. Missing or delaying any of these can delay your listing by weeks or months. Start everything in parallel — do not wait for one to finish before scheduling the next.
- Cardiology consultation and stress test
- SPECT nuclear stress imaging (myocardial perfusion scan)
- Echocardiogram (ejection fraction evaluation)
- EKG within 12 months
- Coronary artery disease screening if high risk
- Cardiac clearance letter from cardiologist
- Full dental examination and X-rays
- Treatment of ALL active decay and infection
- Any necessary extractions completed
- Periodontal disease treatment if present
- Written dental clearance letter signed by dentist
- Dental clearance valid for 12 months — may need renewal
- Pulmonary function tests (PFTs) if indicated
- Chest X-ray within 12 months
- CT chest if history of smoking or lung disease
- Sleep study / CPAP compliance documentation if OSA
- Pulmonary clearance letter if required
- HIV test
- Hepatitis B (HBsAg, HBcAb, HBsAb)
- Hepatitis C (HCV antibody + RNA if reactive)
- CMV (cytomegalovirus IgG)
- EBV (Epstein-Barr virus)
- RPR / syphilis screening
- Tuberculosis (TB) testing — PPD or IGRA
- Varicella (chickenpox) titer — vaccinate if negative
- MMR immunization records
- Colonoscopy within 5 years (age appropriate)
- Mammogram (women 40+)
- Pap smear (women — current per guidelines)
- PSA prostate screening (men 50+)
- Skin examination by dermatologist
- Low-dose CT chest if smoking history >30 pack-years
- BMI within acceptable range (typically under 35–40)
- Vascular evaluation (iliac artery / vein assessment)
- Social work clearance — support system confirmed
- Financial/insurance verification
- Medication and substance use review
- Transplant education class completed
- Primary care physician clearance letter
Yes, You Can Travel
After Your Transplant
One of the greatest gifts of a successful transplant is freedom. No more researching dialysis centers at every destination. No more scheduling trips around treatment days. No more limitations on cruises, international trips, or spontaneous travel. You can go anywhere in the world — with some planning.
The Game-Changer: No More Dialysis Center Research
Before transplant, every MAVTG trip plan involved finding a qualified dialysis center, verifying chair availability, confirming insurance compatibility, and building every itinerary around treatment days. After a successful transplant, all of that disappears. You pack your medications, see your transplant team before departure, and go. This is what we are working toward.
When Is It Safe to Travel?
Most transplant centers recommend waiting at least 3–6 months before domestic travel, and 6–12 months before international travel. The highest-risk period for rejection is the first 6 months while your immunosuppression is being titrated. After 1 year with stable function and stable medication doses, travel restrictions are generally lifted. Always check with your transplant team — timelines vary by patient.
Medication Management Abroad
Your immunosuppressants (tacrolimus, mycophenolate, prednisone) are non-negotiable — you take them for life. Travel with a 2-week extra supply, keep medications in carry-on luggage only, carry a letter from your transplant center listing your medications, and know the international names for your drugs. Never skip a dose, even with time zone changes. Many transplant teams use specific blood levels, so maintain your dosing schedule carefully.
Infection Precautions on the Road
Post-transplant immunosuppression means you are more vulnerable to infections. Sun protection is critical (skin cancer risk is significantly elevated). Avoid raw or undercooked meat and unpasteurized dairy. Drink bottled water in high-risk countries. Avoid large crowds during flu season. Update all travel vaccinations — but note that live vaccines (yellow fever, live oral typhoid, MMR) may be contraindicated. Talk to your transplant team before any travel vaccinations.
Travel Insurance and Medical Access
Purchase comprehensive travel insurance that covers pre-existing conditions and includes medical evacuation. Carry your transplant center's 24-hour emergency contact number. Know the nearest major hospital at your destination. Medicare does not cover care outside the United States — ensure your supplemental coverage does. A medical alert bracelet identifying you as a transplant recipient is a smart precaution.
Required Labs and Follow-Up While Traveling
In the first year post-transplant, labs are drawn frequently — weekly, then monthly. If you travel, you need access to a local lab that can process creatinine, tacrolimus levels, and CBC. Most national lab chains (Quest, LabCorp) can accommodate this with a requisition from your transplant center. Build your travel dates around scheduled lab windows, or arrange remote labs in advance.
Florida Transplant
Resources
Florida has several high-volume transplant programs. Tampa General Hospital's Transplant Institute is one of the largest and most experienced in the Southeast. Knowing your options across the state can help you consider multi-center listing.
Tampa General Hospital — TGH Transplant Institute
One of the busiest transplant programs in the Southeast. Performs kidney, liver, heart, lung, and pancreas transplants. The Transplant Institute team includes transplant nephrologists, surgeons, coordinators, social workers, and dedicated living donor specialists. Located on Davis Islands in the Tampa Bay area.
contact@care.tgh.org → 813-844-7000 tgh.org/services/transplant ↗UF Health Transplant Center — Gainesville
The University of Florida Health Shands Transplant Center is an academic center with a kidney transplant program and research focus. Affiliated with the UF College of Medicine. May be an option for multi-center listing for patients in Central or North Florida.
ufhealth.org/transplant-center ↗ 866-273-4566UF Health Jacksonville
UF Health in Jacksonville also offers transplant services for patients in Northeast Florida. Another potential multi-center listing option for patients near the I-75 corridor or willing to travel to the Jacksonville area.
ufhealthjax.org ↗ 904-244-4000Miami Transplant Institute — Jackson Health
One of the largest transplant programs in the country by volume. For South Florida patients or those willing to travel to Miami, the Miami Transplant Institute performs a high volume of kidney transplants annually and has extensive living donor program infrastructure.
miamitransplant.org ↗ 305-585-6000National Kidney Foundation of Florida
Florida chapter of the National Kidney Foundation. Provides patient education, peer mentorship programs, kidney disease screenings, and advocacy resources. Great starting point for newly diagnosed CKD or ESRD patients.
kidney.org/offices/florida ↗ 800-638-2227UNOS Patient Resources
The United Network for Organ Sharing (UNOS) maintains the national waitlist, publishes data on wait times by center and blood type, and provides patient education tools. Use the UNOS Transplant Center Locator to research center wait times before choosing where to list.
transplantliving.org ↗ 888-287-8771Costs & Insurance
What to Expect
A kidney transplant costs $150,000–$400,000 in total — but Medicare covers approximately 95%. With the right supplemental coverage, your out-of-pocket costs can be manageable. Understanding your coverage before the transplant prevents financial surprises after.
| Cost Category | Approximate Cost | Medicare Covers | Your Exposure | Notes |
|---|---|---|---|---|
| Transplant surgery & hospitalization | $100,000–$200,000 | Medicare Part A — 80% after deductible | ~$1,600 deductible + 20% | Medigap covers the 20% in most plans |
| Pre-transplant evaluation | $10,000–$30,000 | Medicare Part B — 80% | 20% of approved amount | Medigap covers 20% |
| Immunosuppressant medications — Year 1 | $15,000–$25,000/year | Medicare Part D — after formulary | Deductible + copays | Choose Part D plan with low tier for tacrolimus. Patient assistance programs available. |
| Immunosuppressants — Lifetime | $5,000–$20,000/year ongoing | Part D covers for 36 months post-transplant as ESRD benefit | After 36 months, need Part D | Critical: Do not lose Part D coverage after 36 months. Medication is lifelong. |
| Post-transplant follow-up visits | $500–$2,000/visit | Medicare Part B — 80% | 20% after deductible | Frequent visits Year 1 — 2–4x/month initially |
| Living donor evaluation & surgery | $50,000–$100,000 | Recipient's Medicare covers all living donor costs | No cost to donor | Donors pay nothing. This is a common misunderstanding that prevents donations. |
| Biopsy (rejection workup) | $3,000–$8,000 | Medicare Part B — 80% | 20% | May occur 1–3x in first year; Medigap covers 20% |
Transplant FAQ
Questions we hear most often from patients and families navigating the transplant process.
Can I be on the waitlist while still on dialysis?
Yes — being on dialysis is actually a requirement for accumulating waitlist time in most cases. Your clock runs while you are on dialysis, even before you are formally listed at a transplant center. If you started dialysis before being listed, ask your transplant center about back-dating your wait time credit to your dialysis start date. This is one of the most important conversations to have early in the process.
How long will I be in the hospital after a kidney transplant?
The typical hospital stay after a kidney transplant is 3–7 days, assuming no complications. Patients with immediate graft function (the transplanted kidney works right away) are often discharged in 3–4 days. Patients with delayed graft function — where the kidney takes days or weeks to begin working — may stay longer or require continued dialysis temporarily after transplant. This is not uncommon and does not necessarily mean the transplant failed.
Will I need dialysis after my transplant?
Most patients stop dialysis permanently after a successful transplant. However, some experience delayed graft function (DGF) — where the transplanted kidney takes days to weeks to begin functioning. During this period, temporary dialysis may be required. DGF is more common with deceased donor kidneys than living donor kidneys, and most cases resolve. A very small percentage of transplants fail early and require returning to dialysis — this is why continued support on the waitlist is important.
Does my potential living donor have to be a blood relative?
No. Living donors do not need to be blood relatives. Friends, coworkers, neighbors, faith community members, and even strangers (altruistic donors) can donate. Blood type compatibility is helpful but not required — paired exchange programs can match incompatible donor-recipient pairs across the country. The only requirement is that the donor is healthy, motivated, and passes the medical and psychological evaluation. Telling the myth that donors must be relatives has prevented many thousands of transplants.
What happens to my Medicare when I get a transplant?
If you have ESRD Medicare (Medicare due to kidney failure), your ESRD Medicare continues for 36 months after a successful transplant. After 36 months, if you are under 65 and your transplant is functioning, you may lose ESRD-based Medicare eligibility unless you have another qualifying disability or turn 65. This is a critical planning window. Enroll in a Medigap plan and a Part D drug plan before you lose your guaranteed issue rights. Missing this transition can leave you without coverage for immunosuppressants — which can lead to rejection.
Can I eat normally after a transplant?
Many of the strict dietary restrictions from dialysis ease significantly after a transplant with good kidney function. Potassium and phosphorus restrictions are often reduced or eliminated. However, new dietary considerations emerge: grapefruit and pomelo must be avoided (they interfere with tacrolimus metabolism), food safety becomes more important due to immunosuppression, and weight management is important since steroids can cause weight gain. Most transplant centers provide a registered dietitian to guide the post-transplant diet transition.
How long does a transplant last, and what happens if it fails?
Living donor kidneys last an average of 15–20+ years; deceased donor kidneys average 10–15 years. Many patients outlive their first transplant. If a transplant eventually fails, patients can return to dialysis and re-list for a second transplant. Second transplants are absolutely performed and can be successful, though they carry somewhat higher immunological complexity. Maintaining medication compliance, attending every follow-up appointment, and avoiding infections are the most important factors in graft longevity.
What does MAVTG offer transplant patients specifically?
MAVTG was built from the inside of a kidney disease diagnosis. We offer personal guidance on navigating the pre-transplant process, multi-center listing strategy, living donor outreach support, and post-transplant travel planning. After transplant, we specialize in helping patients reconnect with travel and life without dialysis constraints. Contact us — guidance is personal, real, and based on lived experience, not textbooks.
Questions About
Your Transplant Journey?
Every patient's situation is different. Whether you're newly listed, struggling with the pre-transplant checklist, looking for a living donor, or planning life after transplant — reach out. We answer from experience, not from a pamphlet.
Get Personal Guidance →MAVTG provides patient education and peer guidance — not medical advice. All treatment decisions should be made in consultation with your transplant team and physicians. MAVTG is not affiliated with Tampa General Hospital, UNOS, or any transplant center.