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What are the first steps to becoming a living donor?

If you are interested in being a living donor, you should contact the Living Donor Kidney Program at a kidney transplant center. You will usually be asked to fill out a questionnaire. Once you have completed the questionnaire, a nurse coordinator will review it to determine if you may proceed with initial blood testing. The living donor team is your advocate and will not give the recipient any information about your health or your decision to be a donor unless you authorize it.

Once your blood typing and genetic testing are done (to determine if you are a compatible match with the recipient) the living donor nurse coordinator will discuss the results and the donation process with you. He or she will answer any questions so that you can make an informed decision about proceeding with the donation. This conversation is strictly confidential and is not shared with the recipient. If you decide to continue with donation, you must then complete a comprehensive evaluation.

If the surgery will be done at University of Minnesota Medical Center, we encourage you to have your donor evaluation at our Transplant Center in Minneapolis, Minnesota. Our staff can often complete the work-up in one to two days, though you may need additional testing in some cases.

You will complete a medical history and receive a physical, which includes a blood pressure check. This helps ensure that you don’t have any concerning health conditions.

We will then complete a series of laboratory tests and X-ray tests, as well as an EKG, to screen you for kidney function, liver function, hepatitis, heart disease, lung disease and past exposure to viral illness. We will also do urine testing to make sure that your kidneys function normally. In addition, we will ask you to send our living donor team the results from your routine annual health maintenance tests (e.g., pap smear, mammogram, colonoscopy, etc), as well as any necessary medical clearance for pre-existing conditions. Additional tests may be necessary depending on the results of these studies.

You will also have a CT angiogram (a computerized tomography, or CTA) scan. During this scan, our staff will inject contrast into your blood stream through a vein in your arm. The contrast travels to the kidneys and urinary tract while the CTA scan and X-rays are done. These tests help the transplant staff to determine if your urinary tract, kidneys, and the blood vessels leading to the kidneys are normal. These procedures are done in the hospital on an outpatient basis. The scan takes about an hour and does not affect your ability to drive a car. We require that you have the scan at the University of Minnesota Medical Center to ensure the quality of radiographic 3D construction of the kidney vessels.

Your Team
You will meet with a nephrologist, a transplant surgeon, and a social worker during the pre-transplant process. The physicians will assess your medical status for being an appropriate donor. The clinical social worker will complete a psychosocial evaluation.

Once all results from the entire evaluation process are available, a multidisciplinary committee will review them to decide whether you are able to safely proceed with the donation. The living donor coordinator will be your advocate through out the entire process.

Your surgeon and nurse coordinator will discuss all health risks with you. The risks of donation are similar to those involved with any major surgery, such as bleeding and infection. Death resulting from kidney donation is extremely rare. Current research indicates that kidney donation does not change life expectancy or increase a person's risks of developing kidney disease or other health problems.

Posted: 1/11/2010 11:39 a.m. by Barry Friedman, R.N.

Comments:

 Speaking as a donor I know that I benefited long term from the pre-donation exam because it provided MUCH more in-depth informtion about my own physical condition than any other exam I'd ever had.

Posted: 1/28/2010 1:44 p.m. by Rachel