How You Can Save a Life
One focus at NationalKidneyCenter.org is to promote the concept of living donor programs, so that more people learn about this treatment as a viable option. Part of making living donor transplants an option for more people involves letting people just like you know that they can become a living donor. By doing so, you have the power to not only improve a patient’s quality of life, but to also save that person’s life.
In order to determine whether or not you could be a viable donor, you would need to visit a transplant center and complete several tests.
What tests determine if someone can be a kidney donor?
Living Donor Registries
There now are several Internet sites specifically designed to match patients with living kidney donors. The more living donors who participate in the registry program, the greater the chance of finding a match. The donor registries typically charge a fee for their matching service. To register as a donor, visit these registry sites:
The following is a reprint, edited version of information compiled and created by the National Kidney Foundation.
What tests determine compatibility requirements of a kidney donor?
Potential donors will have blood, urine and radiology tests to determine suitability for donation. A full physical examination will be done and psychology evaluation may also be required.
Before surgery, special x-rays will be taken of the donor’s kidneys, including either a renal arteriogram or spiral CT scan to check the kidney anatomy. Additional blood tests called tissue or HLA typing may also be done to determine the quality of matching between the donor and the recipient. The closer the match, the less likely the kidney will be rejected.
The following process is generally used to determine if someone can be a donor.
This is a general description of the testing process, and may vary from center to center:
- A financial consultation will be used to determine financial and insurance coverage for the testing process and the donation itself. Generally, if the donation is to a family member or friend, the recipient’s insurance will pay for testing and surgery expenses. However, the donor might be responsible for travel expenses (if the donor and recipient live in different towns/states) and follow-up care, in addition to lost wages. Since donors are never financially compensated, be sure to ask the financial counselor and/or social worker at the transplant center for assistance with these issues.
- Immunological tests: A blood sample is taken for the following tests:
- Blood type.
The blood type (A, B, AB, or O) must be compatible between the donor and recipient. Blood type requirements of the kidney donor are the most important matching factor.
- Human leukocyte antigens (HLAs).
Your cells carry six important HLAs, three inherited from each parent. Family members are most likely to have a complete match. Kidneys can be received by a patient even if the HLAs aren’t a complete match as long as the blood type is compatible.
- Cross-matching antigens.
The last test before implanting an organ is the cross-match. A small sample of blood from both the donor and recipient will be mixed in a tube to see if there’s a reaction. If no reaction occurs, the result is called a negative cross-match, and a transplant operation can proceed.
- Blood type.
- Laboratory tests. A blood sample is taken to:
- Assess the hematological system, clotting mechanism, and baseline kidney function
- Screen for abnormal electrolyte balance and for glucose intolerance which might occur post transplant
- Screen for venereal disease, pancreatitis, and liver abnormalities, until the cause is found (fluid overload, acute or chronic hepatitis). Also screen for Hepatitis B and the HIV virus.
- Look for past or present viral activity
- If the donor is CMV positive, the recipient may need to receive Cytogam and gancyclovir post transplant to prevent reactivation of the disease.
|Blood Type||Can receive kidney from:||Generally can donate a kidney to:|
|O||O||O, A, B, AB|
|A||A, O||A, AB|
|B||B, O||B, AB|
|AB||O, A, B, AB||AB|
- An EKG will be performed to assess heart function. A chest x-ray will be used to assess the lungs for the presence of any abnormalities.
- A medical history review and physical examination. An extensive review of all systems, including previous illnesses and surgeries and past family medical history. Any abnormalities found are investigated further before invasive tests are performed.
- A psychological evaluation will be used to:
- Provide emotional support and kidney transplant information to the donor
- Assess the donor’s motivation.
- Help the staff work with the donor and family prior to, and after kidney transplant surgery.
- Female donor candidates may undergo a gynecological exam and mammography.
- Kidney function tests. Urine samples are taken to:
- Screen for kidney disease or any abnormalities
- Determine the absence or presence of a urinary tract infection.
- Assess the amount of protein excreted in a 24-hour period. An increased secretion of protein would need to be evaluated before resuming the evaluation; the creatinine clearance is to determine adequate kidney function and to ensure that the 24 hour collection is an adequate one.
- Determine glomerular filtration rate (GFR) which measures “how fast” the kidney can clear a known substance.
- An intravenous pyelography test may be used. This test involves an injection of dye into a vein in your arm. The dye circulates through your body, into your kidneys, and then into your urinary tract. X-rays are taken to identify the structure of the kidney, veins, arteries, the ureter, and other anatomy.
- A Helical CT Scan is done in some transplant centers and is used to evaluate the internal structure of the kidney and look for the presence of cysts, tumors, etc.
- Some transplant centers will perform a renal arteriogram if there is a question of an abnormal finding on the Helical CT Scan. The renal arteriogram is an x-ray which looks at the vasculature of each kidney: the number of blood vessels to and from each kidney, or any evidence of vascular disease that might rule out donation. This test requires an observation period post-exam of 6-8 hours and in some instances may require hospitalization. This is the last test done.
When the 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 depends upon the availability of the donor for testing, the results of the completed tests, and the individual policies and procedures of the transplant center involved.