Renal Transplant


	UM Guidelines

Renal Transplant

Inpatient and Surgical Care (ISC) ORG: S-1015

BCBST modification December 17, 2010*

Deleted:

There were no deletions.

Added to: Clinical Indications

A supportive family / social milieu

No history of previous malignancies or be cancer-free for five years

No untreated and unreversed serious infections

No surgical contraindications such as urologic or vascular problems (e.g., advanced aortoiliac vascular disease)

No active drug and/or alcohol use (must be alcohol and/or drug-free for six months as documented by randomized drug screen)

Sources

BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2009). Kidney transplant (7.03.01). Retrieved December 21, 2009 from BlueWeb. (11 articles and/or guidelines reviewed)

BlueCross BlueShield of Tennessee network physicians December 2010.

Complete Guide to Medicare Coverage Issues. (2009, July). Transplantation (Section 140, p. 4-145 - 4-148).

	Added to: Clinical Indications


	A supportive family / social milieu No history of previous malignancies or be cancer-free for five years No untreated and unreversed serious infections No surgical contraindications such as urologic or vascular problems (e.g., advanced aortoiliac vascular disease) No active drug and/or alcohol use (must be alcohol and/or drug-free for six months as documented by randomized drug screen)
	Sources BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2009). Kidney transplant (7.03.01). Retrieved December 21, 2009 from BlueWeb. (11 articles and/or guidelines reviewed) BlueCross BlueShield of Tennessee network physicians December 2010. Complete Guide to Medicare Coverage Issues. (2009, July). Transplantation (Section 140, p. 4-145 - 4-148).