Many key decisions about listing patients to transplant are made today by a multidisciplinary team (MDT). The clinical team will have standards that define the members required to make an MDT quorate. For a renal MDT this typically means at least one nephrologist, one surgeon, one H&I scientist, one donor coordinator nurse and one patient coordinator nurse. Other potential members include a psychiatrist and a patient advocate. The MDT would also typically have access to a cardiologist, though they may not necessarily attend all meetings.

Two key responsibilities of the renal MDT are to review all potential renal patients for suitability for addition to the deceased donor transplant waiting list and to review all live donor transplants. In considering patients for the deceased donor waiting list, the MDT will typically review the patient’s current kidney status, including creatinine level and glomerular filtration rates (GFR), HLA type, HLA antibody status and matchability, cardiac condition, diabetes and any other relevant clinical history and potential immunosuppression strategy.

In considering patients and donors for live transplant, the MDT will review H&I laboratory results including any crossmatch results, as well as patient and donor clinical history. The MDT would consider whether or not a direct transplant is possible/desirable or whether the pair should be entered into the exchange scheme. The MDT may also review some patients post-transplant, though this may be taken up at a separate meeting such as a biopsy meeting.