Kidney failure and transplants

Warren Silberman

• Former Manager, FAA Aerospace Medical Certification 
• Doctor of Osteopathic Medicine 
• Expert in Aerospace/Preventive Medicine 
• Pilot since 1986

The FAA does not grant special issuance to airmen who are undergoing renal hemodialysis. These individuals may require dialysis at least every three days or so, and are considered “brittle.” If a dialysis patient contracts certain types of illnesses associated with renal disease, the person could “decompensate” and the kidney failure could worsen, requiring emergent dialysis. 

The FAA wants anyone who is contemplating presenting their case for certification to take care of getting their health stabilized first! At the end of the six-month waiting period, the person would need to obtain all the hospital admission and discharge summaries, kidney function tests at admission, the operative report, any pathology reports, and the reports of renal function at the time of hospital discharge. At the end of the six-month period, the treating physician must provide a detailed status note that explains what the original kidney disease was that resulted in the failure, how the airman has performed during the previous six-months, and a current list of medications, noting any medication side effects. Also, current lab work including renal function studies, electrolytes to include calcium and phosphorous, and a complete blood count should be provided. It should always go without saying that the report should be typed. The FAA accepts all immunosuppressive medications that are used to prevent rejection. They will generally place the airman on a waiver (special issuance) that is valid for one year and renewable annually provided there is no adverse medical change.   

Should you have more specific questions, visit AOPA's Medical Certification webpage to consult the medication list for specific medication questions.  

For more information on the AOPA Pilot Protection Services program, visit www.aopa.org/pps.

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The FAA grants special issuance authorizations to airmen who have had certain organ transplants. They require a six-month "period of observation" after the transplantation surgery takes place. The most common organ transplant seen at the FAA is kidney. At the year ending Dec. 31, 2011, which is the last time organ transplant data was collated, out of approximately 600,000 airmen with medical certficates, there were 35 first-, 28 second-, and 71 third-class airmen flying with kidney transplant special issuance authorizations.