Transplantation may be described as a process of transferring living tissues or an organ from one person to another or one site to another to repair a defect. In this case, the kidney is transplanted.

Kidney transplantation is an alternative treatment to dialysis for patients with end-stage renal disease (ESRD), or those who have suffered traumatic loss of a kidney.

Manifestations related to terminal renal failure should serve as the basis for consideration for transplantation. The exception is those at risk from another life-threatening condition.

In general, normally scheduled preoperative measures are performed, e.g., a physical examination, laboratory tests to identify infection, electrolyte studies, abdominal x-rays, and an electrocardiogram (EKG).

Transplantation is the treatment for ESRD and traumatic loss of a kidney. Patients undergoing this surgery require a great deal of preparation and support. For at least the first three months after surgery, patients are advised to avoid: crowds and contact with people with known or suspected infections, heavy lifting, excessive bending, and contact sports. In addition, positions that may result in pressure at the area of the new kidney are to be avoided. After kidney transplantation is completed, patients are required to remain on immunosuppressant drugs for the rest of their lives.

Compliance by the patient with all medications is extremely critical. Patients are maintained on a managed plan to avoid rejection. Most rejection events occur within the first three to four months after transplantation; however, most patients will return to normal health and activity. Complications that may occur after transplantation include, but are not limited to: irreversible chronic graft rejection; drug toxicity; underlying renal disease; infection; and adverse effects of immunosuppressant drugs. Furthermore, patients who have had kidney transplants are at an increased risk (ten to fifteen times higher than normal) of acquiring epithelial cancer, and thirty times higher at risk of developing lymphoma.

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date.  38 CFR 3.951(a)

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.

• The 100 percent evaluation shall be assigned as of the date of hospital admission for transplant surgery and shall continue with a mandatory VA examination one year following hospital discharge. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 CFR 3.105(e) of this chapter.

• GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes when determined to be appropriate and calculated by a medical professional.