The principles behind the workup on the road to being a kidney donor are to ensure that the individual is in good health, with no unrecognized medical disease, and with no issues which would negatively impact kidney function in the long term (uncontrolled high blood pressure, overt diabetes, etc).
You start the process by declaring your interest to donate a kidney to the Transplant Program at which time you will be introduced to the Donor Coordinators of the program who will provide you with information to review at your leisure and a package with requisitions for preliminary blood tests to give the Program an initial understanding of what donor program you and your potential recipient might qualify for. Donor programs include: Direct Donation in which you would donate directly to your intended recipient, versus Paired Exchange in which you and your recipient are found to be incompatible on testing but could still go through the donation and transplant processes by “swapping” kidneys with another incompatible donor and recipient pair (or multiple pairs).
Once your blood type and crossmatch blood work is done, and if you remain interested in donation, you will be provided with additional requisitions for more blood and urine testing, and any specialized testing required such as ECG, heart scans (ambulatory blood pressure measurements, MIBI, ECHO, stress test), breathing tests (Pulmonary Function Tests), Gyne testing for females (Pap and Mammogram if of age), Urologic testing for men (PSA), and general cancer screening tests (colonoscopy, fecal occult blood testing).
These batteries of tests can take multiple appointments to the lab or facility to perform and thus the time to complete will depend on your availability as well as that of the waiting list of the site where the test is to be performed.
You will then be scheduled for interviews with the Transplant Team members including: Donor Coordinator, Social Worker / Psychologist, Nephrologist and Transplant Surgeon. Each team member will interview you to assess different aspects of the donation process: emotional and financial support, access to accommodation and travel arrangements, underlying anxiety or psychological inputs to donation, medical candidacy, and finally surgical candidacy and procedure specifics.
Depending on the outcome of these interviews, you may have additional testing in followup to complete before a final decision as to your candidacy for kidney donation can be made.
At this point, all the testing is complete and the interviews done. This process can take as little as a week to up to 6 months or longer depending on a variety of factors. When your file is ready (and that of your recipient as well), your case will be discussed at our Transplant Team Rounds, and individual acceptability of the donor and recipient are performed, and if both are acceptable, the compatibility is checked again, and a decision is then made for entering the queue for surgery. For those donors who are directly donating to a specific recipient, the surgery date can be set usually within a 3 month timeframe (depending on the readiness of the recipient as well). For those donors who are entering the Living Donor Paired Exchange (LDPE) program, this is a National program where you and your recipient’s files are entered into a federal database, and “match runs” are conducted at periodic intervals through the year (about 5x per year at present). If your files are selected for a particular “chain” of transplants, the logistics can still take several months to sort out as these operations are required to be conducted within days of each other, but may occur at multiple sites across the Country simultaneously.
At any point throughout the workup and proceedings, right up until the day of surgery, you as the donor have the right to back out, and there will be no repercussions to you in any way.