Kidney Transplant

Diagnosis Kidney transplant
Department Nephrology and Hypertension; Pediatric Nephrology; Urology

1. Start the referral process:

For adult kidney transplant, download our forms:

For pediatric kidney transplant, use your own referral form or notes* or download our form:

2. Gather records:

For adult referrals, Nephrology and Hypertension:

  • Most recent H&P (within last 12 months)
  • Last 2 sets of labs (CMP, CBC)
  • Medicare 2728 form, if on dialysis
  • Rounding report or Treatment Log, if on dialysis
  • Recent diagnostics, if available
  • Vaccine history, if available

For Pediatric Nephrology:

  • Chart notes
  • Labs
  • Ultrasound report

For adult referrals, Urology:

  • Records from all providers previously treating Dx

3. Fax the referral and all records:

  • For adult kidney transplant:
    • Fax the referral and all records to 503-494-4492.
    • For questions, contact Clinic Transplant Services, Kidney Pancreas Transplant Program at 503-494-8500 or 800-452-1369, x8500.

       
  • For pediatric kidney transplant:
    • Fax the referral and all records to 503-346-6854.
    • For help or to arrange provider-to-provider advice, call 503-494-4567.

* Referral notes or forms should include:

  • Patient name, date of birth, sex, address and phone number
  • Referring provider’s name, address and phone number
  • Diagnosis or reason for referral
  • Department patient is being referred to
  • Most recent chart notes supporting the diagnosis or reason for referral
Date Revised May 01, 2024