So you’ve made the decision to become a living donor. You’re not alone. In the United States in 2013, there were 5,733 living kidney donors. Since 1988, there have been 127,515 living kidney donors in the United States. In 2011, living donors accounted for 42.5% of the kidney transplants performed globally, and there were more than 31,000 live donor transplants done in more than 100 countries around the world.
What’s next? After you’ve made the decision that you want to donate, the testing process begins to determine whether you would be an eligible donor. The process may vary slightly at different transplant centers, but generally the following occurs:
- Blood tests and samples are taken to determine donor and recipient compatibility. These include immunological tests to determine the donor’s blood type compatibility and tissue typing to find out the donor and recipient’s particular HLA antigens, which indicate the likelihood that the kidney would be rejected once transplanted. If an entire family is being tested, blood samples will be taken of all potential donors to determine compatibility.
- A physical examination to evaluate the health of the donor. This involves a review of medical and family history, including all previous illnesses and surgeries, as well as a physical examination. The physical exam includes laboratory tests to determine baseline kidney function and screen for diseases and abnormalities that may put the donor and/or recipient at risk. Female donor candidates may undergo a gynecological exam and mammography. An EKG will also be performed to assess heart function. A chest x-ray will be used to assess the lungs for the presence of any abnormalities. Any abnormalities found are investigated further before invasive tests are performed.
- A psychological evaluation. This is used to provide emotional support and information to the donor and assess the donor’s motivation. Also, if the potential donor determines that he or she does not want to donate, the transplant team can help the donor decline in a way that preserves the family relationships. This evaluation gives the donor an opportunity to express him or herself more fully than she might to the physician, or with the recipient or family present, especially if there is family pressure or financial incentive to donate.
When all of the necessary tests are completed, the results are presented to the transplant team (surgeons, nurses, social workers, financial counselors, etc.) to determine if the person is a suitable candidate for donation. The length of the testing process can vary depending on the availability of the donor for testing, the results of the completed tests, and the individual policies and procedures of the transplant center involved.
If you and the transplant team determine that it’s a good fit to proceed with kidney donation, you may be wondering what happens next? Once you are accepted by the transplant team, you should have a final meeting with the surgeon to discuss expectations, surgical technique, and answer any final questions about the surgery. You will also need to meet with an anesthesiologist about the techniques used for providing anesthesia during your surgery and pain control after the surgery. At that point, a date can be set that is suitable for both you and your recipient.