Living Donation Evaluation
There are several tests and exams that potential living donors must complete during their evaluation. To be considered as a living donor. Potential living kidney donors need to be in good health and have normal kidney function and anatomy.
Living Donor Testing Process
Health Maintenance Required Tests Not Covered By The Transplant Center
The transplant center also requires that your health maintenance testing is up to date, but does not cover the cost of these tests. Required health maintenance testing includes: Regularly scheduled PAP Smears for all women, yearly mammograms for all women over the age of 40, and routine colonoscopies for all potential donors over the age of 50.
Out of Town Donors
For out of town donors, all testing and clinic appointments can be set up within a two day period. For example, you could fly into Albuquerque on a Sunday evening, have all of your appointments on Monday and Tuesday, and fly back home Tuesday evening. For the surgery, you will need to plan on being in the Albuquerque area for a minimum of 2 weeks for a pre-surgical review, final crossmatch testing, the surgery and approximately 8-10 days of post-surgical care.
For donors who reside greater than 60 miles from Albuquerque, there are certain recipient insurance providers that will allow for the reimbursement of some to all of the travel expenses incurred by donors. Some donors may also qualify for
National Living Donor Assistance. The social worker is available to help you with this application process.
All of the following tests are paid for by the transplant center. The surgery and hospital stay are covered by the recipients insurance.
Blood Type Compatibility
The first step is determining blood type compatibility.
Compatible Blood Types
Recipient Blood Type||
Donor Blood Type|
|A||A or O|
|B||B or O|
|AB||A, B, AB or O|
The + and – on blood type does not matter in organ donation.
Fasting Blood Work
The purpose of this test is to make sure that your blood sugar levels do not get too high after drinking the solution. High blood sugar levels with this test can indicate a risk for developing diabetes in the future. You will need to plan on being at the lab for a minimum of 3 hours for this blood draw. We will have you fast, or not eat or drink anything except for water for a minimum of 12 hours prior to having your blood drawn.
24 hour Urine Collection
If all of the fasting lab work comes back okay, we will have you collect all of your urine for a 24 hour period. We know that removing one of your kidneys will decrease your overall kidney function by 25-30%. The purpose of this urine collection is to evaluate your baseline kidney function to see if we can safely take away that 25-30% of your baseline function.
During the preliminary crossmatch, the tissue typing lab mixes your blood with the recipient’s blood to make sure there is not a reaction. If there is a reaction during the preliminary crossmatch we know that the recipient would reject your kidney if we were to transplant it in them.
Transplant Clinic Evaluation
After receiving a negative preliminary crossmatch we will set you up to come to the transplant office to meet with the team. Your first appointment will be approximately 4 hours long. You will meet with the living donor nurse coordinator, the living donor kidney doctor (nephrologist), and the social worker. We will go over the informed consent process with you. If you decide to move forward after meeting with us, we will have you collect some more lab work, a chest x-ray, and an EKG. We will then schedule you for a CT Scan of your abdomen.
The purpose of the CT scan is to make sure you have 2 kidneys, and to evaluate the anatomy of your kidneys. Things that can rule you out on CT Scan are: only having one kidney, having too many blood vessels supplying blood flow to your kidneys, or some type of medical process such as stones or cysts, that may not cause a problem for you with two functioning kidneys but could put you at risk if we were to take one of your kidneys away.
Surgeon and Independent Living Donor Advocate
After the CT Scan we will set you up to come to the transplant office to meet with the surgeon and the Independent Living Donor Advocate. The surgeon goes over all of the surgical risks with you and will be your primary provider while you are in the hospital.
The Independent Living Donor Advocate is someone who works for Presbyterian but does not work for the transplant center. Their job is to protect the of the rights of living donors and potential living donors by ensuring the transplant team has provided the necessary information to the donors to make an informed decision.
Partial List of Contraindications to Living Donation
Living Donor Surgery
The nephrectomy for living donation is done laparoscopically, meaning only three or four approximately one-inch incisions will be made in your abdomen. This minimally invasive procedure is preferred for its low risk for bleeding and complications, and makes for a reduced stay in the hospital.
The expected recovery time from a laparoscopic nephrectomy is four to six weeks. Donors should avoid strenuous activity or heavy lifting during this recovery period.
If it is determined that the donated organ cannot be removed laparoscopically, the surgeon will make a larger, six to eight inch incision in the side of the abdomen to remove the kidney. Expect a six to eight week recovery if this type of organ recovery is needed.
Living Donor: Post-Donation
Post Kidney Donation Follow-up Care
As a living kidney donor, you should not require a change in lifestyle after donation. We do advocate a healthy lifestyle. Eat healthy foods and get plenty of exercise. Avoid gaining too much weight as this may lead to medical conditions, such as high blood pressure or diabetes, which may affect your remaining kidney.
It is recommended that you have an annual follow up with a primary care physician to assess your overall general heath including blood pressure, and blood and urine tests to check kidney function. Future health maintenance examinations, prompt medical care and continued health insurance are extremely important after kidney donation.
We will provide lab order forms for blood work to be completed at three months, six months, one year and two years post donation. The transplant coordinator will contact you to discuss the results and request other medical information.
Any infectious disease or malignancy pertinent to acute recipient care discovered during the first two years of the donors post-operative care may need to be reported to local, state or federal public health authorities and will be disclosed to your recipients transplant center. These findings will also be reported through the OPTN improving patient safety portal.
It is an UNOS/OPTN requirement that our transplant program submit medical information on you for a period of two years after donation. By agreeing to be a living donor you are agreeing to the follow up.
We also recommend that you notify your doctors in the future if you are prescribed a new medication or require a study that requires intravenous dye (e.g. CT scan or angiogram). These may need to be modified because of your single kidney.