Referral Forms

The requirements for organ transplant referrals differ for each program.

Please refer to the appropriate organ group below for information on how to refer a patient for transplant:

Heart

Patients must be referred by their heart specialist to the Heart Transplant Team at St. Paul's Hospital in Vancouver.

Kidney

Patients must be referred by their Nephrologist to the Renal Transplant Program at Vancouver General Hospital or St. Paul's Hospital in Vancouver.

Liver

Patients must be referred by their specialist to the Liver Transplant Team at Vancouver General Hospital in Vancouver.

Form: Liver transplant referral form

Checklist for Transfer of Cirrhotic Patients being Evaluated for Liver Transplant to VGH CTU

Pancreas/Pancreas Islet

Pancreas transplant patients must be referred by a specialist to the Pancreas Transplant Team at Vancouver General Hospital in Vancouver.

Referrals (for either islet with no previous kidney transplant; or islet after kidney transplant) to the BC Islet Transplant Program may come from a referring endocrinologist or from the Renal Transplant program.

Forms:

Pancreas form

Islet form

Lung

Patients must be referred by their lung specialist to the Lung Transplant Team at Vancouver General Hospital, in Vancouver.

Form: Lung and Heart/Lung referral form

Pediatric

Pediatric patients must be referred by a specialist to the BC Children's Transplant Clinic.

Questions?

If you have specific questions about how to refer a patient for transplant, please contact the program centres directly.

Provincial Health Services Authority