Monday, Oct. 21, 2002 - 9:14 P.M.
How do I get started to be a donor? The transplant person in the kidney doctor's office will perform the initial screening by asking questions about your medical history. You may be excluded as a donor without further testing if you have a medical history of diabetes, high blood pressure, heart disease, or if you have a risk of developing kidney disease in yourself in the future. They do not want to put you in jeopardy in any way. They are not pushy. Quite the opposite, YOU will need to make them understand that you WANT to do this and are not being coerced or pushed into it.
Blood Testing:
If you appear to be in good health from the initial screening, a blood sample will be obtained to determine if you are compatible with the intended recipient. You must have the proper A, B or O blood type. You will be considered eligible to donate if your blood type is O no matter what your intended recipient�s blood type is. If you are compatible on the basis of ABO testing, then the tissue match will be determined. The most critical test is called the cross match in which your blood and the recipient�s blood are mixed together to be certain that your tissue typing is compatible with the recipient. If these tests are compatible, you will proceed to the next steps. The results of a cross match can change overtime. For this reason, this test is repeated near the date of the scheduled transplant surgery. An imperfect match may be OK Perfect genetic matches are no longer required for a kidney transplant, mostly because of improved anti-rejection drugs. Still, a living donor and recipient must meet several key prerequisites in order to move forward with a transplant. Blood type. The donor must take a blood test to determine compatibility. Example: My blood type is O, which is compatible with any blood type. If your blood is A, it matches with either A or O. Crossmatching. A blood test is done to see if the recipient has antibodies that might attack a transplanted organ. The white blood cells are mixed with blood serum. If the cells died, person would likely reject donor's kidney. Antigen screen. Each person's cells contain a unique set of up to six antigens, which the body uses to differentiate normal tissue from a foreign substance. Half of a person's antigens are inherited from the mother, half from the father. Blood relatives are more likely to have similar antigen patterns: The more similar these patterns, the less likely it is that an organ will be rejected. Yet a full sibling is not necessarily a better donor candidate than a non-relative.
Evaluation and Testing :
If the initial screening and blood testing show that you might be a suitable donor, additional testing will be performed. This will include more blood tests, urine testing, a 24 hour urine collection, chest x-ray, electrocardiogram, and ultrasound of your kidneys. A PAP smear and mammogram will be required for females. If all of this testing is suitable, you will then undergo a complete physical examination and consultation with a nephrologist (a kidney specialist). The purpose of this thorough testing is to be certain that you have a minimal risk from donation, and that your loved one will receive a healthy kidney. After approval by the nephrologist, a special CT scan of the kidneys will be performed to be certain that both kidneys are normal in appearance and anatomy. Occasionally, additional testing or consultation may be required. The costs of these additional evaluations may be billed to your own health care insurance if the condition is a medical problem that has previously been diagnosed.
While being considered as a possible kidney donor, it is also required that you meet with the Transplant Social Worker. The social worker will talk with you to determine the family, friends, and support systems that you have to assist you through the donation process and recuperation period after surgery. He or she will also discuss issues related to absence from work, lost wages, travel expenses, and child care expenses that you may incur. The social worker will also determine if there are any potential psychological problems that would interfere with your decision to donate a kidney. If there are any concerns, you may be referred to a psychologist or a psychiatrist for further testing.
The final step before the donation and transplant take place is a meeting with one of the transplant urologists. This is the surgeon who will remove your kidney. He will review your records, and explain the operative procedure and its risks.
