The Evaluation Process
The evaluation process for a living kidney donation takes time - perhaps as long as six months. Many tests are done to determine if the donor is healthy enough to donate a kidney and will be a good match for the potential recipient. These investigations and appointments may be time consuming, and require travel and possibly time off work.
The living donor candidate meets with different members of the healthcare team during the evaluation process. These may include nephrologists, transplant surgeons, clinical nurse specialists, nurse practitioners, social workers, transplant coordinators, cardiologists, psychologists and psychiatrists.
Here is an overview of the evaluation process:
- Blood type compatibility. This is a blood test done to see if the blood types of the donor and recipient are compatible. The blood types do not need to be identical. For example, Blood group O is a universal donor and can donate to anyone. The positive and negative Rh factor does not matter in transplantation.
- Assessment of general health. The potential donor undergoes a complete medical history review (including hereditary diseases) and a physical exam including several tests such blood, urine and X-rays. For example, an X-ray of the lungs may be done to determine if there are any abnormalities. Other tests such as electrocardiogram (ECG) may be done to assess heart function. Potential donors who are female may also have a gynaecological exam (including Pap test) and mammogram to make sure there are no underlying medical conditions.
- Compatibility tests. If the basic health screening and laboratory tests are normal, more blood is drawn for testing to determine compatibility between donor and recipient. These special tests are called tissue typing and cross-matching, and they help to determine if the recipient may reject the kidney.
- Determining health of the kidneys. Further tests including urine testing, a kidney ultrasound and CT scan will investigate the health of the potential donor's kidneys.
- Psychosocial assessment.The donor candidate will also go through a psychosocial assessment:
- To give the potential donor an opportunity to express their feelings, motivations, or concerns
- To assess the donor's motivation
- To evaluate if there is any family pressure or financial incentive to donate
- To make sure the donor has all the necessary information to make a decision about donation
- To provide emotional support to the donor during and after the donation process
- To assist the donor in discussing their decision with their family and/or the potential transplant recipient