Becoming a living kidney donor requires a thorough evaluation process designed to ensure the donor’s safety and the transplant’s success. This rigorous testing phase involves a series of medical, surgical, and psychosocial assessments that vary significantly in length. While the total time frame can range from one month to six months or more, the process is broken down into distinct stages. This comprehensive evaluation confirms the donor’s long-term health and compatibility before proceeding with the donation.
Initial Screening and Compatibility Assessment
The first step involves initial contact with a transplant center, usually by completing an online or phone-based health questionnaire. This preliminary screening reviews the donor’s medical and behavioral history and current health status to determine suitability for the full evaluation. This initial review rules out absolute contraindications, such as a history of cancer, uncontrolled high blood pressure, or diabetes, before extensive testing begins.
After initial screening, the focus shifts to compatibility, requiring a simple blood draw for immunological tests. The first test is ABO blood typing to check for compatible blood groups between the donor and recipient. If blood types are compatible, or if the center uses a paired exchange program, tissue typing (HLA typing) and a crossmatch test are performed. These initial lab results, which determine the risk of immediate rejection, typically take a few days to a couple of weeks to process.
Comprehensive Medical Evaluation Timeline
Following the compatibility assessment, the donor begins the comprehensive medical evaluation, the most time-intensive component. Although some centers aim to complete appointments in a single one- or two-day visit, the entire phase of testing and receiving results often spans four to eight weeks. The core of this phase involves extensive lab work to assess overall health and baseline kidney function.
Lab work includes a 24-hour urine collection to measure protein excretion and calculate the glomerular filtration rate (GFR), a key indicator of kidney function. Blood panels assess liver function, check for infectious diseases like HIV and hepatitis, and measure blood sugar levels, sometimes requiring an oral glucose tolerance test.
Cardiovascular health is checked using an electrocardiogram (EKG) and a chest X-ray. For donors over age 50 or those with risk factors, a cardiac stress test may be required.
Imaging studies map the kidney’s anatomy and blood vessel structure, which is vital for surgical planning. A Computed Tomography (CT) angiogram is often used, providing a detailed, three-dimensional view of the renal blood vessels. Female donors may require an updated Pap smear and mammogram, and donors over 50 may need a colonoscopy to ensure preventative health screenings are current. This phase also includes consultations with a transplant nephrologist, a surgeon, a dietitian, and an independent donor advocate.
Factors Affecting the Testing Schedule
The overall timeline is highly variable, often stretching from one month to six months or more due to logistical and medical factors. The speed of the transplant center’s scheduling department is a major factor; larger centers with more staff often schedule appointments and process results faster. The donor’s availability to attend numerous appointments also influences how quickly the tests can be completed.
Medical results introduce delays if initial findings are borderline or abnormal, requiring follow-up testing. For example, an unclear stress test result may necessitate a more advanced cardiac evaluation, or a high blood pressure reading may require monitoring and medication before clearance is given. If a potential donor needs to make lifestyle changes, such as losing weight or quitting smoking, the evaluation is temporarily paused until those health goals are achieved. Delays can also occur due to the time required for insurance authorization for advanced imaging or specialized consultations.
Final Review and Donor Approval Process
Once all required medical tests, imaging studies, and psychosocial consultations are complete, the file moves to the final evaluation stage. This involves a comprehensive review of the entire donor file by the multidisciplinary transplant team. The team, including surgeons, nephrologists, social workers, and independent advocates, meets to discuss all data and collectively determine the donor’s final medical suitability.
This final review process typically takes one to four weeks after the last test result is received. The team’s decision is based on the medical test results, the psychosocial assessment, and the overall risk assessment for the donor. If the donor is approved, the transplant center notifies them, and the process of coordinating the surgery date with the recipient begins.