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How to use or fill out Kidney and Kidney/Pancreas Transplant Consultation Request Form with our platform
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Click ‘Get Form’ to open it in the editor.
Begin with the 'Patient Information' section. Fill in the patient's name, date of birth, gender, and contact details. Ensure you include the last four digits of the SSN and attach insurance cards if required.
Proceed to 'Prescriber Information'. Complete all fields including prescriber’s name, title, and contact information. Specify where the product should be delivered—either to the office or patient’s home.
In 'Clinical Information', provide relevant ICD codes and any known drug allergies. Document weight and height accurately as this information is crucial for treatment.
Finally, review all sections for completeness before submitting. Use our platform's features to sign electronically if needed.
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Can you get a kidney and pancreas transplant at the same time?
A kidney-pancreas transplant is an operation to place both a kidney and a pancreas at the same time into someone who has kidney failure related to type 1 diabetes. In many cases, both transplanted organs may come from one deceased donor.
What is the success rate of a kidney and pancreas transplant?
Our overall patient survival rate at one year is 98%, our kidney transplant survival for one year is 95%, and our pancreas graft survival for one year is 85%-90%.
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Kidney and Kidney/Pancreas Transplant Consultation
To refer a patient to the University of Kentucky Kidney and Kidney/Pancreas Transplant program, please fax this form and your cover sheet to 859-323-1700.
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