{"id":2941,"date":"2026-09-06T18:17:33","date_gmt":"2026-09-06T18:17:33","guid":{"rendered":"https:\/\/bookinghospital.org\/?p=2941"},"modified":"2026-09-06T18:23:48","modified_gmt":"2026-09-06T18:23:48","slug":"who-cannot-have-a-kidney-transplant","status":"publish","type":"post","link":"https:\/\/bookinghospital.org\/ro\/who-cannot-have-a-kidney-transplant\/","title":{"rendered":"Who Cannot Have a Kidney Transplant"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2941\" class=\"elementor elementor-2941\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ae63ddf e-con-full e-flex e-con e-parent\" data-id=\"ae63ddf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4728799 elementor-widget elementor-widget-html\" data-id=\"4728799\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"bh\">\n\n<section class=\"hero\">\n  <div class=\"in\">\n    <p class=\"eyebrow\">Kidney transplantation \u00b7 Before the transplant<\/p>\n    <h1>Who genuinely cannot have a kidney transplant?<\/h1>\n    <p class=\"lead\">Most refusals patients receive are not on this list. It is worth knowing\n       what the real barriers are \u2014 and which of them are permanent.<\/p>\n    <p class=\"meta\">Written by <b style=\"color:#fff\">Profesorul Dr. Murat Tuncer<\/b> \u00b7\n       Adapted from his book <i>Kidney Transplantation \u2014 With Questions and Answers<\/i><\/p>\n  <\/div>\n<\/section>\n\n<section class=\"wrap\">\n\n  <div class=\"ozet\">\n    <h2>The short answer<\/h2>\n    <ul>\n      <li>The list of <b>absolute barriers is short<\/b>, and most of the conditions patients\n          worry about are not on it.<\/li>\n      <li>Nearly every item on the list describes something <b>active or unresolved<\/b> \u2014\n          which means it can often change.<\/li>\n      <li><b>HIV is a relative contraindication<\/b>, not an absolute one. Defined criteria\n          exist and patients who meet them are transplanted.<\/li>\n      <li><b>Cancer is assessed case by case<\/b>, by tumour type and time since treatment.<\/li>\n      <li>One item on the list is not medical at all \u2014 and it is the one worth planning for.<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2>The absolute contraindications<\/h2>\n\n  <p>These are the conditions that genuinely rule out kidney transplantation while they are\n     present:<\/p>\n\n  <div class=\"tblwrap\">\n    <table>\n      <thead>\n        <tr><th>Condition<\/th><th>Permanent?<\/th><\/tr>\n      <\/thead>\n      <tbody>\n        <tr><td>Unresolved cancer<\/td><td>No \u2014 depends on treatment and remission<\/td><\/tr>\n        <tr><td>Active AIDS or active hepatitis<\/td><td>No \u2014 depends on control of the disease<\/td><\/tr>\n        <tr><td>Active tuberculosis<\/td><td>No \u2014 treatable<\/td><\/tr>\n        <tr><td>Severe vascular disease<\/td><td>Usually yes<\/td><\/tr>\n        <tr><td>Active intravenous drug addiction<\/td><td>No \u2014 depends on recovery<\/td><\/tr>\n        <tr><td>Life expectancy under five years<\/td><td>Depends on the underlying cause<\/td><\/tr>\n        <tr><td>Recent myocardial infarction<\/td><td>No \u2014 a matter of timing<\/td><\/tr>\n        <tr><td>Other end-stage organ failure (heart, lung, liver)<\/td><td>May redirect to combined transplantation<\/td><\/tr>\n        <tr><td><b>Inability to afford post-transplant medication<\/b><\/td><td>No \u2014 but it must be solved before surgery<\/td><\/tr>\n      <\/tbody>\n    <\/table>\n  <\/div>\n\n  <div class=\"box\">\n    <span class=\"etiket\">Read the second column<\/span>\n    <p>Most of these are written as <b>\"active\"<\/b>, <b>\"unresolved\"<\/b>, <b>\"recent\"<\/b>. That\n      wording is deliberate. They describe a state at a moment in time, not a permanent\n      characteristic of the patient.<\/p>\n    <p>A contraindication that can end is a <b>delay<\/b>, not a refusal \u2014 and the two should\n      not be communicated in the same sentence.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>The last item on the list<\/h3>\n\n    <p>One entry is not a disease: <b>the patient's inability to obtain their medication after\n       the transplant.<\/b><\/p>\n\n    <p>It sits on the list for a hard reason. Immunosuppressive drugs are not optional and not\n       temporary. A transplanted kidney whose recipient stops taking them will be lost \u2014 and a\n       donated organ will have been wasted along with the donor's surgery.<\/p>\n\n    <p>This is not a reason to hide financial difficulty from a transplant team. It is a reason\n       to raise it early, while it can still be planned around. Teams would far rather solve\n       this before surgery than discover it afterwards.<\/p>\n  <\/div>\n\n  <h2>HIV: a relative contraindication<\/h2>\n\n  <p>HIV positivity is a <b>relative<\/b> contraindication, not an absolute one. Some HIV-positive\n     patients are eligible for kidney transplantation, from a living or a deceased donor.<\/p>\n\n  <p>Published consensus criteria set out what needs to be true:<\/p>\n\n  <ul>\n    <li><b>CD4+ T cell count above 200\/mm\u00b3<\/b> for more than six months<\/li>\n    <li><b>HIV-1 RNA undetectable<\/b> for more than three months<\/li>\n    <li>On <b>highly active antiretroviral therapy<\/b> for more than three months<\/li>\n    <li><b>Free from opportunistic infections<\/b><\/li>\n  <\/ul>\n\n  <p>The specific testing requirements and their timing are planned jointly by the transplant\n     team and the infectious diseases team. Note the distinction on the list above: <b>active\n     AIDS<\/b> is an absolute barrier. Controlled HIV infection is not the same thing.<\/p>\n\n  <h2>Cancer: assessed case by case<\/h2>\n\n  <p>There are two genuine reasons for caution when a transplant candidate has cancer:<\/p>\n\n  <ol>\n    <li>The immunosuppressive therapy given after transplantation <b>adversely affects the\n        natural course<\/b> of cancer.<\/li>\n    <li>Transplantation is <b>not appropriate for a patient whose life expectancy is already\n        short<\/b> because of the cancer itself.<\/li>\n  <\/ol>\n\n  <p>But neither of these makes cancer an automatic disqualification.<\/p>\n\n  <div class=\"box\">\n    <span class=\"etiket\">How it is actually decided<\/span>\n    <p>A history of cancer <b>does not pose a definite obstacle<\/b> to transplantation. Each\n      patient is evaluated separately, according to the <b>type of tumour<\/b> and the\n      <b>tumour-free waiting period<\/b> since treatment.<\/p>\n    <p>Different cancers carry different required waiting times. \"You had cancer\" is not an\n      answer \u2014 the questions are which one, and how long ago.<\/p>\n  <\/div>\n\n  <h2>What is not on the list<\/h2>\n\n  <p>It is worth naming the things patients are commonly told will disqualify them, which do\n     not appear among the absolute contraindications:<\/p>\n\n  <ul>\n    <li><b>Diabetes<\/b> \u2014 diabetic patients may benefit most from transplantation<\/li>\n    <li><b>Hepatitis B or C<\/b> \u2014 not an obstacle unless the liver is cirrhotic<\/li>\n    <li><b>Age<\/b> \u2014 most centres set no upper limit; suitability is assessed, not age<\/li>\n    <li><b>Being overweight or underweight<\/b> \u2014 a reason to correct weight, not to refuse<\/li>\n    <li><b>A previous failed transplant<\/b> \u2014 retransplantation is routine<\/li>\n    <li><b>Poor tissue matching<\/b> \u2014 largely irrelevant with a living donor<\/li>\n    <li><b>Incompatible blood type<\/b> \u2014 paired exchange and ABO-incompatible routes exist<\/li>\n    <li><b>A positive crossmatch<\/b> \u2014 depends on the antibody type<\/li>\n  <\/ul>\n\n  <p>Each of these has been used to send patients away. None of them belongs on the list at the\n     top of this page.<\/p>\n\n  <h2>If you have been refused<\/h2>\n\n  <p>Three questions turn a vague refusal into something you can act on:<\/p>\n\n  <ul>\n    <li><b>Which specific finding was the reason?<\/b> Not \"your condition\" \u2014 the finding.<\/li>\n    <li><b>Is it on the absolute list, or is it a delay?<\/b> The difference is everything.<\/li>\n    <li><b>If it is a delay, what would need to change, and by how much?<\/b> A number you can\n        work towards is a plan. A vague answer usually is not.<\/li>\n  <\/ul>\n\n  <div class=\"yazar\">\n    <div class=\"rozet\">MT<\/div>\n    <div>\n      <h3><a href=\"https:\/\/bookinghospital.org\/ro\/murat-tuncer-md\/\" style=\"color:inherit\">Profesorul Dr. Murat Tuncer<\/a><\/h3>\n      <p>Nephrologist and transplant physician. Author of <i>Kidney Transplantation \u2014 With\n        Questions and Answers<\/i> (Istanbul, 2020), written to answer the questions his own\n        patients ask most often.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta\">\n    <h2>Was your refusal on the list?<\/h2>\n    <p>Send us the reports and the reason you were given. We will tell you honestly which it\n       was \u2014 including when the answer is that the refusal stands.<\/p>\n    <div class=\"btns\">\n      <a class=\"btn btn-1\" href=\"https:\/\/bookinghospital.org\/ro\/medical-tourism\/\">Send your medical reports<\/a>\n      <a class=\"btn btn-2\" href=\"\/ro\/category\/kidney-transplant-guide\/\">More patient guides<\/a>\n    <\/div>\n  <\/div>\n\n  <div class=\"uyari\">\n    <p><b>Medical disclaimer.<\/b> This article is general information adapted from a published\n      book. It is not personal medical advice, it does not establish a doctor\u2013patient\n      relationship, and it cannot replace assessment by the physician treating you.\n      Contraindication criteria differ between centres and change as treatments improve. Always\n      consult your own nephrologist or transplant centre before making decisions about your\n      treatment.<\/p>\n  <\/div>\n\n  <div class=\"kaynak\">\n    <h3>References<\/h3>\n    <ol>\n      <li>Knoll G, Cockfield S, Blydt-Hansen T, et al. Canadian Society of Transplantation\n        consensus guidelines on eligibility for kidney transplantation.\n        <i>CMAJ<\/i> 2005;173(10).<\/li>\n      <li>Kasiske BL, Cangro CB, Hariharan S, et al. The evaluation of renal transplantation\n        candidates: clinical practice guidelines.\n        <i>Am J Transplant<\/i> 2001;1(suppl 2):3\u201395.<\/li>\n      <li>Rao PS, Merion RM, Ashby VB, Port FK, Wolfe RA, Kayler LK. Renal transplantation in\n        elderly patients older than 70 years of age: results from the Scientific Registry of\n        Transplant Recipients. <i>Transplantation<\/i> 2007;83:1069\u201374.<\/li>\n    <\/ol>\n  <\/div>\n\n<\/section>\n\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Kidney transplantation \u00b7 Before the transplant Who genuinely cannot have a kidney transplant? Most refusals patients receive are not on this list. It is worth knowing what the real barriers are \u2014 and which of them are permanent. Written by Prof. Dr. Murat Tuncer \u00b7 Adapted from his book Kidney Transplantation \u2014 With Questions and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_joinchat":[],"footnotes":""},"categories":[16],"tags":[],"class_list":["post-2941","post","type-post","status-publish","format-standard","hentry","category-kidney-transplant-guide"],"_links":{"self":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts\/2941","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/comments?post=2941"}],"version-history":[{"count":4,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts\/2941\/revisions"}],"predecessor-version":[{"id":2946,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts\/2941\/revisions\/2946"}],"wp:attachment":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/media?parent=2941"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/categories?post=2941"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/tags?post=2941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}