Living kidney donation involves a person giving one of their healthy kidneys to another individual who needs a transplant. This act can significantly improve the recipient’s quality of life and longevity. Before a donation can proceed, potential donors undergo a thorough and comprehensive evaluation process. This assessment is designed to confirm the donor’s overall health and ensure the safety of both the donor and the recipient throughout the donation journey.
Initial Steps to Become a Donor
The process of becoming a living kidney donor begins with contacting a transplant center. Many centers offer an initial screening questionnaire or phone conversation to gather preliminary health information and assess general eligibility. This initial contact helps determine if an individual meets broad criteria, such as being healthy and within a typical age range (18-70 years), though this varies by center.
Basic health prerequisites are discussed. These include no history of major chronic diseases like uncontrolled diabetes, significant heart disease, or active cancer. The transplant team also assesses conditions that might compromise the remaining kidney’s function after donation. This initial screening filters out individuals who are not candidates before extensive testing begins.
Detailed Medical Assessment
A comprehensive medical assessment follows initial screening, involving tests to evaluate kidney function, overall health, and recipient compatibility. Blood tests are a central component. These tests include ABO blood typing to confirm compatibility, as recipients need a compatible blood type. Desensitization protocols can sometimes allow for ABO-incompatible transplants.
Further blood analyses involve tissue typing (Human Leukocyte Antigen or HLA typing), which assesses genetic markers to find the best match. Crossmatching checks for pre-formed antibodies in the recipient’s blood that could react against donor tissues, potentially leading to immediate rejection. Viral screenings are conducted for infections like HIV, hepatitis B, and hepatitis C to prevent transmission.
Kidney function is assessed through blood tests measuring creatinine levels and calculating the glomerular filtration rate (GFR), which indicates kidney filtering efficiency. A 24-hour urine collection measures protein levels and creatinine clearance, providing an in-depth look at kidney performance. Imaging studies provide anatomical details, including an ultrasound and a CT angiogram of the kidneys to visualize blood vessels and kidney structure.
Additional imaging, such as a chest X-ray or electrocardiogram (EKG), may assess heart and lung health. Depending on initial findings or medical history, consultations with specialists (nephrologists, cardiologists, oncologists) may be arranged. These consultations ensure underlying health conditions are evaluated and managed before a final donation decision.
Psychological and Social Evaluation
Potential kidney donors undergo psychological and social evaluations. These assessments, conducted by mental health professionals and social workers, ensure the donor makes an informed, voluntary decision. The psychological evaluation focuses on understanding the donor’s motivation, emotional preparedness, and ability to cope with surgery and recovery stresses.
This evaluation also assesses mental health status, screening for conditions that might affect understanding of donation risks and benefits. The social assessment explores the donor’s support system, including family, friends, or others who can provide recovery assistance. Financial stability is also considered, ensuring the donor is not coerced or receiving illegal financial gain.
The social worker discusses the donor’s ability to take time off work for surgery and recovery, and their understanding of living with one kidney long-term. These non-medical evaluations confirm the donor acts autonomously and has necessary resources to navigate the process successfully.
After the Evaluation: What Happens Next?
Once medical, psychological, and social evaluations are complete, the transplant team reviews findings. This multidisciplinary team (surgeons, nephrologists, social workers, psychologists) assesses donor suitability. They consider all evaluation aspects to decide if the individual is a safe and appropriate candidate for living kidney donation.
The transplant center communicates the evaluation outcome to the potential donor. If approved, the team discusses next steps, including scheduling surgery and providing pre-operative instructions. If not approved, the team provides a clear explanation. In such cases, the transplant center may discuss alternative options for the recipient, such as exploring other living donors or placing them on the deceased donor waitlist.