What tests do potential donors complete?
A potential living donor must meet basic medical criteria and undergo a thorough medical evaluation before being accepted as a donor. Before completing a full evaluation, a potential donor has a preliminary blood test to determine blood- and tissue-type compatibility. (However, incompatible blood types do not necessarily prevent one from donating. If the donor wishes, he or she can instead be considered for a paired donation. (See “Paired Donation” under “Compatibility.") Usually, the potential donor is also asked to report approximately 5 blood-pressure readings. (Fire stations offer free blood pressure readings.)
While various transplant centers have their own donor testing procedures, in general, if the preliminary blood test results are acceptable, the center will proceed with any other preliminary tests that may be needed. A full evaluation includes a medical history review, thorough physical, urine collections, glucose-tolerance test, chest X-ray, EKG, and any other tests deemed necessary by the transplant team. Any abnormaliities that may be found are investigated further. Occasionally, a potential donor’s own lifespan is significantly improved when the evaluation uncovers a previously unknown health condition and leads to treatment for it. The final test is a CT scan that allows a detailed look at the potential donor’s kidneys.
The donor evaluation includes a psychosocial assessment. The purpose of this assessment is not to rule out potential donors but to enhance a potential donor's experience by tending to his or her individual circumstances. Information gathered during this evaluation helps transplant team members tailor their work around donor and family needs, both before and after surgery. The evaluation also provides an opportunity for the donor to express concerns more fully than he or she might with a physician or with the recipient or family present. Part of the assessment is devoted to discussion regarding the potential donor's motivation: It is important to verify that the donor is not being pressured to donate and to confirm that he or she is not volunteering for unethical reasons, such as being paid for the donation (which is illegal in the U.S.) To those who volunteer to donate to a stranger (called altruistic donors), it can appear that the evaluator is opposed to and even trying to discourage the donation. The reason, however, is to ensure that the potential donor is choosing to donate for truly altruistic reasons and not for self-serving purposes.
Donors usually attend an orientation and are asked to bring a support person who can be available to the donor throughout the donation process. The orientation gives donors an opportunity to talk individually with the medical professionals with whom they will be working. Potential donors are given printed materials, and a small-group educational program provides details about the donor journey. The staff at most transplant centers are available to address questions or concerns by phone throughout the entire process. Living donors get extra special, well-deserved care...after all, a kidney donation is a gift far beyond measure.
How long does a donor evaluation take?
An evaluation takes usually longer than one might at first suppose. An evaluation that proceeds "quickly" may take 3 months. Often, the process takes 6 months or longer. The potential donor plays a significant role in determining the length of the evaluation. Those who are readily available, able to be flexible in scheduling, and can follow up quickly on miscellaneous details can keep the process moving steadily forward.
I live quite some distance from the recipient. Would I have to travel for the evaluation?
Generally, if a potential donor resides a great distance from the recipient's transplant center, he or she may complete the testing closer to home at a facility that is able to coordinate with the recipient's center. If, during the evaluation, a health problem that requires further investigation is uncovered, the donor may be required to pursue it at the recipient's center (assuming the donor still wishes to donate). Presumably, anything very minor--the proverbial hangnail--would not require long-distance travel. A prosective donor is not expected to bear the expense of meals or travel necessary to complete the evaluation. (See Medical Bills.)
Insurance does not cover non-medical expenses such as transportation, lodging, and meals. However, federal funding and other programs such as the National Living Donor Assistance Center are available to receipients and donors who qualify.
Dominos: Keenan Cheung hugs his kidney donor, Reginal Griffin. The two men took part in a double chain that freed 6 patients from dialysis. The chains were initiated by altruistic donors Nichole Langstrum and Harry Damon, who are pictured below. Click here to read the story.
Altruistic Dominos: Nichole Lanstrum, an Air Force intelligence analyst, and Harry Damon, a Michigan firefighter, initiated 2 transplant chains by each volunteering to donate a kidney to someone they did not know. The chains freed 6 patients from dialysis, including Keenan Cheung, who received a kidney from Reginal Griffiin, pictured above. Click here to read another version of their story.