Kidney transplant and your FAA medical
What the FAA's Guide says the examiner needs for kidney transplant, in plain words.
FAA term: Renal Transplant (Kidney Transplant)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
RENAL TRANSPLANT (Kidney Transplant) All Classes
- The FAA's liver transplant table has its own row for combined transplants, and it names liver + kidney. The renal transplant table's Row B does not say where each organ's items are listed.
- The FAA's heart transplant table has a page of its own. The renal transplant table's Row B names kidney + heart and does not say where each organ's items are listed.
- The FAA's Item 41 table, on the chronic kidney disease page, has a row for ESRD requiring dialysis or kidney transplant.
The short answer
The FAA's disposition table for renal transplant is for all classes and has two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ARenal transplant | Defers to the FAA | Special Issuance |
| Row BCombined transplants | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Kidney transplant
- Row A · Special Issuance
A renal transplant. After a six (6) month recovery period, the table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
A. Renal Transplant After a six (6) month recovery period, submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
- Row B · Special Issuance
Combined transplants: kidney + pancreas, kidney + liver, kidney + heart, or kidney + other. The table says to submit the required items for each individual organ transplanted. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
Combined Transplants Kidney + Pancreas Kidney + Liver Kidney + Heart Kidney + other Submit the required items for each individual organ transplanted. DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
The FAA pathways for kidney transplant
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: the recovery period
The table's list is for after a six (6) month recovery period.The table lists what to submit for FAA review after a six (6) month recovery period.
Show the FAA's words: Row A: the recovery period
A. Renal Transplant After a six (6) month recovery period, submit the following for FAA review:
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
Step 2: Row A: the progress note
From your nephrologist or transplant surgeon.Within 90 days before the examA current, detailed progress note from a clinic visit with your nephrologist or transplant surgeon, no more than 90 days before the exam.
It should include
- A summary of the history of the condition or diagnosis
- Current medications, dosages, and side effects (if any)
- Clinical exam findings
- Results of any testing performed
- Diagnosis
- Assessment and plan (prognosis)
- Follow-up
Show the FAA's words: Row A: the progress note
1. A current, detailed Clinical Progress Note generated from a clinic visit with nephrologist or transplant surgeon no more than 90 days before the AME exam. It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
Step 3: Row A: the table's second item
Specific items for your physician to address.The table's second item: it must specifically include these.
It must specifically include
- Etiology of primary renal disease
- Symptoms or complications prior to transplant
- Compliance with post-transplant treatment
- Any history of rejection or graft versus host disease (GVHD)
- Hypertension or heart dysfunction
- Any problems or side effects related to immunosuppressive medication, particularly calcineurin inhibitors
- Cardiac risk assessment
Show the FAA's words: Row A: the table's second item
2. It must specifically include: • Etiology of primary renal disease • Symptoms or complications prior to transplant • Compliance with post-transplant treatment • Any history of rejection or graft versus host disease (GVHD) • Hypertension or heart dysfunction • Any problems or side effects related to immunosuppressive medication, particularly calcineurin inhibitors • Cardiac risk assessment
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
FAA source: Pilot Information – What a Detailed Clinical Progress Note must contain. FAA date 25 September 2024; checked by Crosscheck 11 November 2026.
Step 4: Row A: labs, hospital records and other testing
The labs, the records from the hospital or clinic, and any other test results.Labs
Within 90 days before the examLabs no more than 90 days before the exam.
The labs
- CBC (complete blood count)
- CMP (complete metabolic profile)
- Hemoglobin A1c
- Urine protein-creatinine ratio
Hospital or clinic records
Hospital or clinic records, to include the items below.
To include
- Admission history and physical (H&P)
- Operative notes (op note)
- Discharge summary from the physician
- Not: The discharge instructions or paperwork given to the patient when leaving the hospital
Other test results
If already performed.
If already performed.
The results of any other testing already performed for this condition.
Show the FAA's words: Row A: labs, hospital records and other testing
3. Lab. Performed no more than 90 days before the AME exam: a. CBC (complete blood count) b. CMP (complete metabolic profile) c. Hemoglobin A1c d. Urine Protein-Creatinine Ratio
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
4. Hospital or clinic records to include: • Admission history & physical (H&P) • Operative notes (op note) • Discharge summary from the physician (NOT the discharge instructions/paperwork given to the patient when leaving the hospital)
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
5. Results of any other testing already performed for this condition. Note: After review of the above, additional information may be required.
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
Step 5: See your AME
After a six (6) month recovery period, the table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.Exam day- After a six (6) month recovery period, the table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
Show the FAA's words: See your AME
A. Renal Transplant After a six (6) month recovery period, submit the following for FAA review:
DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
FAA source: Renal Transplant (Kidney Transplant). FAA date 28 October 2026; checked by Crosscheck 11 November 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row ADefers to the FAASpecial Issuance
After a six (6) month recovery period, the table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
If the examiner defersRow BDefers to the FAASpecial Issuance
The table says to submit the required items for each individual organ transplanted. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
A renal transplant. After a six (6) month recovery period, the table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
A. Renal Transplant After a six (6) month recovery period, submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
- Row B · Special Issuance
Combined transplants: kidney + pancreas, kidney + liver, kidney + heart, or kidney + other. The table says to submit the required items for each individual organ transplanted. The examiner defers, submits the information to the FAA for a possible Special Issuance and summarizes elements or findings in Item 60.
Combined Transplants Kidney + Pancreas Kidney + Liver Kidney + Heart Kidney + other Submit the required items for each individual organ transplanted. DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
If the examiner defersSpecial Issuance
The table marks Row A, renal transplant, DEFER, for a possible Special Issuance.
The table marks Row B, combined transplants, DEFER, for a possible Special Issuance.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row A, renal transplant, DEFER, for a possible Special Issuance.
A. Renal Transplant … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks Row B, combined transplants, DEFER, for a possible Special Issuance.
Combined Transplants … Submit the required items for each individual organ transplanted. DEFER Submit the information to the FAA for a possible Special Issuance.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
The six-month recovery period
Row A's list is for after a six (6) month recovery period. The table does not say when the period starts, and Row B's text does not repeat it.
Show the FAA's words: good to know, 2
A. Renal Transplant After a six (6) month recovery period, submit the following for FAA review:
"It must specifically include"
Row A's second item reads "It must specifically include:". The FAA's progress-note sheet says that language highlights specific items (that may or may not be part of a standard current, detailed Clinical Progress Note), and to make sure the physician addresses them.
Show the FAA's words: good to know, 3
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
Hospital records not to send
The table says the discharge summary is the physician's, not the discharge instructions or paperwork given to the patient when leaving the hospital.
Show the FAA's words: good to know, 4
• Discharge summary from the physician (NOT the discharge instructions/paperwork given to the patient when leaving the hospital)
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
Related pages
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.