The process of receiving a kidney transplant is long, complex, and varies greatly depending on where someone lives and how unwell they are. For many people supported by Purple House, the journey can take anywhere from six months to several years.
The Transplant Work-Up Process 
Before someone can be added to the transplant list, they must undergo a thorough health assessment known as the “work-up” to show that they are healthy enough to have a successful transplant. Purple House plays a key role in supporting people through this long and often difficult work-up phase, helping them attend appointments, access tests, and navigate the health system. This process involves:
- Dental care: Many people haven’t had regular dental care before starting the transplant journey. Gum disease or unresolved dental issues can cause infections, so multiple dental visits and ongoing treatment are often required before someone can be cleared for the list.
- Eye checks Routine eye examinations are needed to rule out complications that could be exuberated by a transplant, especially in people with diabetes.
- Skin checks: Fungal infections and other skin conditions need to be managed to reduce the risk of complications. These need to be kept under control to stay on the transplant list.
- Heart, lung, and liver checks These vital organs must be thoroughly assessed to ensure the person is strong enough for surgery and recovery.
- BMI and overall health Weight and general fitness are also assessed. For people living with diabetes, there are often additional complications that need attention.
- ENT referrals Chronic ear infections are common and often require treatment from ear, nose and throat specialists.
- Blood Tests Regular blood tests are used to monitor overall health and to identify compatibility with potential donors.
Staying “Well Enough” to Stay on the List
Even once someone is on the transplant list, staying there is not guaranteed. People must be in excellent health to remain “active” on the list, and it’s common for half of the list to be temporarily deactivated due to illness or infections. This means that even if a matching kidney becomes available, they may not be eligible to receive it at that time. Being on the transplant list requires constant vigilance – staying infection-free, managing chronic conditions, and maintaining good overall health. This is especially challenging for people living remotely or those who prefer to return home to be with their families. While basic tests can be done on Country, many specialist treatments require travel back into town, creating a difficult balance between home, family and health care access.
Post-Transplant Care
Receiving a kidney transplant isn’t the end of the journey – in many ways, it’s just the beginning. After a transplant, people are placed on immunosuppressant medications which make them more vulnerable to infections and illness. This means they must continue to manage their health very carefully, addressing not only medical issues but also the social determinants of health, such as housing, nutrition, and access to primary care. Ongoing tests and monitoring continue for years after surgery, especially in the early months when the risk of complications is high. Education and support are critical during this phase – and this is where Purple House’s preceptors play a key role, helping people learn how to care for themselves and understand their new responsibilities.
Transplant is Not the Gold Star – Prevention Is
While a transplant can offer people a new lease on life, it is not an option for everyone, it is high risk, and it is not a cure. “Transplant is not the gold star – prevention is.” Preventing kidney disease in the first place, or catching it early, is ultimately the better path. There is also a great deal of anxiety for people on the transplant list. The long wait, the health pressures, and the constant hope for a match can be mentally exhausting. Purple House continues to walk alongside people throughout this journey – providing not just medical support, but emotional and cultural care too.