What to Expect When Becoming a Living Donor
Evaluation tests will be done in stages.
First, the potential living donor must call the living donor hotline at (309) 624-5433 and speak to a transplant team member. The team member will take some basic information and pass the referral on to a living donor coordinator.
The living donor coordinator will discuss the donation, answer your questions and send an information packet to you.
After reviewing the information, you will complete the enclosed donor questionnaire and detailed health history and return it to the transplant office in the provided envelope.
The questionnaire and any available medical records will be reviewed with the physicians and health care team for an evaluation process plan.
Your recipient must be approved for transplant by the transplant team before further testing. There may be several potential donors for one recipient, but only one donor will be evaluated at a time.
Your donor evaluation will also include being seen by the transplant health care team, including a surgeon and a nephrologist, living donor coordinator, social worker, financial coordinator, dietitian, pharmacist and independent living donor advocate.
The decision about whether to accept the donor is made by the transplant center health care team.
The testing you can expect during your evaluation process includes:
- Blood work will be drawn to confirm your blood type and basic screening labs to check your kidney function, screen for diabetes, and check your urine for abnormalities.
- 24-hour urine collection to evaluate the function of your kidneys.
- HLA tissue typing: this blood test checks the tissue match between the donor and the recipient. Your cells have six human leukocyte antigens (HLA): three from each parent. This is why family members are most likely to have matching antigens. A complete HLA match is not required as long as the blood type matches and other tests are negative.
- Cross-match: this test involves mixing the donor and recipient blood sample to see if there is a reaction that would cause a potential rejection of the transplanted kidney. If no reaction occurs, the result is called a negative cross-match, and the transplant operation can proceed. If a reaction does occur, the result is called a positive cross-match, meaning that the risk of rejection of the kidney is too high. In this case, the donor and recipient may decide to explore a paired kidney exchange option or another donor may step forward and start the evaluation process.
- Chest X-ray and EKG to evaluate your heart and lungs.
- Blood tests to screen for possible transmissible diseases: these tests may determine if the donor has had or been exposed to HIV/AIDS, hepatitis, or other diseases. Some positive test results may need to be reported to local, state, or federal health authorities for public health reasons.
- CT angiogram of kidneys - an X-ray test to evaluate the anatomy of the kidneys and blood vessels.
- Cancer screening testing as age and risk-appropriate may include a colonoscopy, mammogram, Pap smear, prostate exam, and skin cancer screening.
- Any additional testing as needed
Independent Living Donor Advocate
Federal regulations require transplant programs to appoint an independent donor advocate to ensure safe evaluation and care of living donors.
An independent living donor advocate’s role in counseling potential living donors includes but is not limited to:
- Identifying potential emotional risks to the donor.
- Determining whether the donor can make the decision to donate and cope with the stress of major surgery.
- Exploring the rationale for donation to be sure the donor is free of pressure or guilt.
- Discussing how donation might impact the donor’s job or family relations.
- Reviewing the nature of the relationship between donor and recipient
For more information on living donor assistance, visit the National Living Donor Assistance Center.
Donor Financial Information
Medical expenses associated with the living donor evaluation are covered by either the Transplant Centers Organ Acquisition Fund (OAH) or, in certain circumstances, the recipient's insurance. In either case, the living donor should not incur any expenses for the evaluation.
However, it’s important to remember that travel, lodging, and wage reimbursement are not covered by insurance. Basic health maintenance cancer screenings are the responsibility of the donor's insurance.
Some donors may qualify for assistance with wage reimbursement and/or travel expenses related to their kidney donation. Our social worker will discuss these programs with the potential living donor.
- Determining the support systems that are in place for recovery.
- Ensuring the donor understands risks of complications, recovery phase, and financial aspects of donation and commitment to postoperative follow-up care.
- Reinforcing that the transplant center will not discuss the donor evaluation with the recipient.