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Penn Transplant Institute KIDNEY TRANSPLANT PROGRAM Kidney Living Donor Referral Form Thank you for your interest in living kidney donation The Penn kidney transplant team is committed to helping you help others. 615. 3814 or send back to Penn Transplant Program Living Kidney Donor Program PCAM- 2 West 3400 Civic Center Blvd. Philadelphia PA 19104. Once your referral form is received a member of the kidney living donor team will contact you within two business days. Philadelphia PA 19104....

How to fill out donor referral form

How to fill out Penn Medicine Kidney Living Donor Referral Form

1. Begin by downloading the Penn Medicine Kidney Living Donor Referral Form from the official website.
2. Fill in the patient’s personal information including name, date of birth, and contact details.
3. Provide the name of the potential living donor along with their contact information.
4. Complete the section regarding the patient's medical history and current health status.
5. Indicate any previous kidney transplants or treatments related to kidney health.
6. Sign the form, confirming that all information is accurate to the best of your knowledge.
7. Submit the completed form via email, fax, or by mailing it to the specified address on the form.

Who needs Penn Medicine Kidney Living Donor Referral Form?

1. Individuals who are seeking a kidney transplant and wish to consider living donor options need to fill out the Penn Medicine Kidney Living Donor Referral Form.
2. Family members or friends of patients looking to donate a kidney can also fulfill this requirement.

People Also Ask about kidney donor form pdf

Do they leave your kidney in when you get a kidney transplant?

The kidney transplant procedure involves 3 main stages: First, an incision (cut) is made in your lower abdomen (tummy), through which the donated kidney is put into place. Your own kidneys will usually be left where they are, unless they're causing problems such as pain or infection.

Do you live a normal life after kidney transplant?

A successful kidney transplant may allow you to live longer and to live the kind of life you were living before you got kidney disease. For many patients, there are fewer limits on what you can eat and drink, though you should follow a heart-healthy diet and maintain a healthy weight to help your new kidney last.

How long can a person live with a kidney transplant?

On the other hand, patients who receive a kidney transplant typically live longer than those who stay on dialysis. A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years.

What disqualifies you from getting a kidney transplant?

You may not be eligible to receive a kidney transplant due to: The presence of some other life-threatening disease or condition that would not improve with transplantation. This could include certain cancers, infections that cannot be treated or cured, or severe, uncorrectable heart disease.

Can you live a full life with a kidney transplant?

People can live for many years after receiving a transplanted kidney. On average, a kidney from a living donor lasts about 12 to 20 years, while a kidney from a deceased donor lasts about eight to 12 years. Some people receive more than one kidney transplant in their lifetime.

Can a kidney transplant last 30 years?

Kidneys. How long transplants last: living donors, 10 to 13-year graft half-life; deceased donors, 7-9 years. Longest reported: 60 years.

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What is Penn Medicine Kidney Living Donor Referral Form?

The Penn Medicine Kidney Living Donor Referral Form is a document that initiates the process for referring a potential living kidney donor to the Penn Medicine transplant program.

Who is required to file Penn Medicine Kidney Living Donor Referral Form?

The form must be filed by healthcare professionals, such as physicians or transplant coordinators, who are referring a patient for potential living kidney donation.

How to fill out Penn Medicine Kidney Living Donor Referral Form?

To fill out the form, the referring healthcare professional needs to provide detailed information about the potential donor and their medical history, as well as confirm the donor's willingness to donate.

What is the purpose of Penn Medicine Kidney Living Donor Referral Form?

The purpose of the form is to collect essential information about potential living donors to evaluate their eligibility and facilitate the kidney transplant process.

What information must be reported on Penn Medicine Kidney Living Donor Referral Form?

The form requires information such as the donor's personal details, medical history, psychosocial evaluation, and any relevant laboratory testing results.