Get the free Adult Kidney/Pancreas Transplant Candidate Registration Worksheet - unos
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Records Adult Kidney/Pancreas Transplant Candidate Registration Worksheet FORM APPROVED: O.M.B. NO. 0915-0157 Expiration Date: 03/31/2015 Note: These worksheets are provided to function as a guide
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How to fill out adult kidneypancreas transplant candidate
How to fill out an adult kidneypancreas transplant candidate:
01
Start by gathering all necessary information and documents. This may include medical records, test results, and personal identification documents.
02
Fill out the basic personal information section. This includes the candidate's full name, date of birth, address, phone number, and emergency contact information.
03
Provide details about the medical history of the candidate. Include any previous surgeries, treatments, or relevant medical conditions.
04
Fill out information about the current state of the candidate's kidneypancreas health. This may include details about the function of the kidneys and pancreas, and any complications or symptoms experienced.
05
List any medications currently being taken by the candidate. Include the names, dosages, and frequency of intake.
06
Provide information about any allergies or sensitivities the candidate may have, especially those related to medications or medical procedures.
07
Include a comprehensive family medical history. This should include any genetic conditions or diseases that may increase the risk of kidneypancreas complications.
08
Provide a detailed description of the candidate's lifestyle and habits. This may include information about smoking, alcohol consumption, exercise, and diet.
09
Upload any relevant medical records or test results. These can help support the candidate's case for a kidneypancreas transplant.
10
Answer any additional questions or provide any other requested information as required by the transplant center or medical professionals involved in the evaluation process.
Who needs an adult kidneypancreas transplant candidate:
01
Individuals who have been diagnosed with end-stage renal disease (ESRD) and also have significant pancreatic dysfunction may require a kidneypancreas transplant.
02
Adults who have been diagnosed with type 1 diabetes and kidney failure may be considered for a kidneypancreas transplant.
03
Candidates who are experiencing complications associated with kidneypancreas dysfunction, such as uncontrolled blood sugar levels, frequent hospitalizations, or reduced quality of life, may be eligible for a kidneypancreas transplant.
Please note that the eligibility criteria for an adult kidneypancreas transplant can vary depending on the transplant center and the individual's specific medical condition. It is essential to consult with medical professionals specialized in transplant medicine to determine if a kidneypancreas transplant is the right option for each individual case.
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