Becoming a living kidney donor
Donor evaluation
If the transplant team decides you can continue, you’ll start an evaluation process. This is the process of checking if a person is healthy enough to donate a kidney and if donating is safe for them in the short- and long-term.
The purpose of the evaluation is to:
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Make sure that donating 1 kidney will not hurt donors medically, emotionally, or financially
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Make sure a transplant is likely to have a good outcome for the potential transplant recipient
To protect donors, if the evaluation results show that the risks are too high, you may not be approved to be a potential donor.
What questions and tests happen during donor evaluation?
To make sure you are healthy enough to donate, you will take a lot of tests. Your medical information and test results are confidential. By law, transplant centers cannot share your medical information with the transplant recipient without your permission.
Here are the kinds of questions and tests potential living donors can expect during evaluation. Each is described below:
The transplant team will ask you questions about your life. This helps you and the transplant team decide if living donation is right for you. Here are some examples of the questions:
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Why do you want to donate?
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Do you feel pressure from anyone to donate?
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How well do you understand the process, risks, and benefits so that you can make an informed choice?
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How will donating affect your life? Your family?
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Will donating affect your job? Your finances?
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How might donating affect other parts of your life, such as caring for a child or a parent?
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Who will help you during recovery from surgery?
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What are your family’s views about your donation?
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Do you have any mental health issues that could be made worse by donating?
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How do you think you will feel after donating?
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How do think you will feel if things don’t go as you had hoped?
Some of the questions are really personal. The purpose is to make sure donation is safe and right for you.
Be sure to ask any questions you have. There is no such thing as a bad question or too many questions. Answering all of your questions is one of the most important jobs of the transplant team. Bring a family member or friend with you to help you remember everything you need to know.
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Some blood tests give the transplant team information about your health. Other blood tests show them if you are a match with a transplant recipient.
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Blood type compatibility: Blood tests let the transplant team know if you and a transplant recipient have compatible blood types.
If your blood type is...
The recipient's blood type must be...
O
A, B, AB, or O
AB
AB
A
A or AB
B
B or AB
If your blood type is...
The recipient's blood type must be...
If your blood type is
O
The recipient's blood type must be
A, B, AB, or O
If your blood type is
AB
The recipient's blood type must be
AB
If your blood type is
A
The recipient's blood type must be
A or AB
If your blood type is
B
The recipient's blood type must be
B or AB
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Tissue typing: This blood test checks the tissue match between you and a transplant recipient. Transplant teams use this information in caring for transplant recipients. Even if you and the recipient are not tissue matched, the recipient can still have a successful transplant because of medicines to avoid organ rejection.
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Cross-matching: This blood test checks for factors that may raise the chance of organ rejection by the transplant recipient.
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Transmissible diseases: These blood tests look for infections or conditions that a living donor could spread to the transplant recipient. The law requires medical staff to report certain infections confidentially (privately) to public health officials.
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A chest x-ray, an electrocardiogram, and other tests to make sure your heart and lungs are healthy enough for you to be a donor
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Imaging tests, such as a CT or MRI scan, to let the transplant team look at your kidneys
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Blood and urine (pee) tests to learn more about your kidney health
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Routine tests depend on your age and the tests you have had in the past, and may include:
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A colonoscopy
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Skin cancer screening
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Gender-specific exams (such as a mammogram for women, or a prostate exam for men)
Not all transplant centers require the same tests. The transplant team will explain what tests you need. They also will explain why the tests are important.
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Support from a donor advocate
If you start donor evaluation, the transplant center will assign you an independent living donor advocate (ILDA).
An ILDA’s job is to protect you. Their job is not to think about what the transplant recipient needs or make transplants happen. The ILDA will:
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Protect you and your best interests
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Support your rights, such as making sure you have the time and information you need to decide if donating is right for you
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Make sure you know the risks and benefits of living donation
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Help you walk away if you decide living donation is not right for you
The ILDA will make sure you have information about:
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Consent: When you agree to give medical information and undergo testing
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Evaluation: What tests you need to take and why
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The surgery: What to expect the day of the operation and the risks
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Recovery: What to expect after surgery and getting back to normal activities
ILDAs want you to share anything that is on your mind. If you have fears, concerns, or second thoughts, your ILDA wants to know. Sharing your thoughts is the best way to help your ILDA support you and help you decide what is right for you.
The advocate will not share your medical or other information with the transplant recipient.
How long does evaluation take?
Meeting the transplant team and doing testing at the transplant center can take 1-2 days. The overall evaluation process can take several months because you may need additional testing. This depends on transplant team scheduling and how quickly you can get the tests done.
Where is evaluation done?
Donor evaluation is done through the transplant center. You may go to a hospital or lab for blood draws or other lab tests.
If you are donating to someone whose center is far away, you may be able to do some of the medical tests closer to your home. Talk with the transplant staff about options.