Evaluating Donor Health

Once you're a match to donate a kidney directly, altruistically or through a paired exchange, the focus turns to you and your health. It's time for the next round of tests and evaluations to make sure you're healthy enough to donate. The process takes time, pee (a lot) and more blood, but in the end, you'll have an inside-and-out look at the state of your health—something most of us don't take time to get on our own. 

Tests and Evaluations

Tests and the process can vary slightly by transplant center. The donor coordinator schedules testing at your convenience. It can take up to a full day, or sometimes it's scheduled over two half days, depending on your medical history. It's typically done at the transplant center where you'll have surgery. If you're donating through the National Kidney Registry and you live out of town, it usually can be done at the nearest transplant center. Generally, the tests and evaluations can include:

Physical exam

This is the same as an annual exam you have with your primary care doctor. The doctor or nurse practitioner will do a physical exam and go over basic health history questions.

Urine test

You collect your urine (every drop) for 24 hours for tests that evaluate your kidney function. You also give an addition urine sample to check for any abnormalities that may be a sign of kidney damage or infection.

X-Ray 

A chest X-Ray checks for heart and lung disease.

Electrocardiogram 

An electrocardiogram (EKG) evaluates your heart rhythm and screens for previous heart injury.

CT scan

This test provides an in-depth look at the anatomy of your kidneys—the blood vessels going to and from them—and screens for kidney stones. 

Psychological evaluation 

You talk with a social worker who is your advocate throughout the process. The social worker will want to know more about your relationship with the recipient and why you're donating to be sure you're not under any pressure to donate. She talks with you about your support system and any history of depression or other mental illness. 

The social worker plays devil's advocate of sorts, making sure you understand everything that's involved with donating—potential risks and the impact of having surgery on your family and work life, for example. This will be one of many times during the process you're reassured that you can change your mind about donating at any time. Your decision is kept in strict confidence.

Colonoscopy

If you're over 50, you'll need this routine test that rules out colon cancer. If you've had this test in the past year, those results will be used. 

Pap smear and mammogram

If you've had these routine tests within a year, those results will be used.

Meeting with other transplant team members

Your donor coordinator meets with you during the testing phase to go through a face-to-face explanation of the donation process with you. You also meet with a surgeon who explains the surgery and recovery in detail. It's another chance for you to ask questions and talk over any concerns you might have.

Pre-op testing

A week or two before surgery you and your recipient will have tests to make sure nothing about your health has changed. Those tests can include bloodwork, urinalysis, an EKG, and chest X-ray. You also have another physical exam and talk over the details of the surgery and discharge/recovery with the social worker, surgeon, and your donor coordinator.

Final blood test

This is the final comparison of your blood cells and recipient’s blood serum to make sure the recipient has not created any antibodies that would attack the donated organ.

After you complete the tests and evaluations, the transplant team reviews the results and decides if you are eligible to donate. If so, your transplant coordinator schedules the surgery and final pre-op testing.