Evaluation Process

After a review of the potential donor's information

Financial considerations

Recipients may have a benefit through their health insurance that would offset the cost of travel and lodging for potential living donors. Your recipient is encouraged to speak with his or her insurance provider to find out if they have this benefit. In addition, there may be other financial resources available to assist you with travel and lodging expenses. NLDAC is a federally-funded program providing financial assistance to those who want to donate an organ, priority is given to recipients and their donors who are not otherwise able to afford the travel and lodging expenses associated with living organ donation. If you are considering organ donation, NLDAC may be able to lessen the burden of travel expenses.

Medical and Psychosocial Review

The donor evaluation includes the following tests. However, additional testing may be required:

• Blood tests to determine overall health and prior exposure to infectious diseases
• Urine tests to evaluate kidney function
• Blood pressure readings to assess for high blood pressure
• Electrocardiogram (EKG)
• Chest X-ray
• 2-hour Glucose Tolerance Test and hemogliobin A1C to screen for diabetes in donors with a family history of diabetes, donor candidates who are overweight or donors who have an elevated fasting blood glucose
• Cardiac Stress test may be required for donors over the age of 50.

The following tests may be requested, but will not be paid for by UCLA.

• Pap Smear for all females
• Mammogram for female donors who are 40 years or older
• Colonoscopy may be required for donors over the age of 50.

A thorough evaluation by a UCLA nephrologist for a review of the completed test results and a history and physical is next.  The nephrologist may request more testing after their evaluation.

Each donor must undergo psychosocial evaluation with the transplant psychiatrist and/ or social worker.  This interview ensures the donor is comfortable with the decision to donate and has explored all of the concerns that may apply to donation.  A potential donor’s decision to donate must be strictly voluntary.  No emotional coercion or monetary compensation may have been given or promised for a kidney.

The urine tests done at the beginning of the evaluation help determine that the kidneys are functioning properly.  A CT Urogram (CTU), a dye test imaging of the kidneys, will be performed to provide the surgeon with a picture of the structure of the kidneys.  Upon review of these results, the surgeon decides which kidney will be removed for donation.

Risks of donation

The hospital staff must make sure you know about the following risks. Ask your Independent Living Donor Advocate to explain any risks you do not understand.

Potential medical risks that could happen during the evaluation:

• Being allergic to a test and having a bad reaction.
• Discovery of an infection the hospital staff need to report.
• Discovery of a serious medical condition that could require more medical tests or treatment that you will have to pay for.
• Discovery of a genetic health risk factor or issue that you did not know about.

Potential surgical or medical risks that could happen if you donate an organ:

• Death or disease (being very overweight, older or having high blood pressure or other medical conditions could make you more likely to die or have a problem).
• Scars, hernia, infection, blood clots, pneumonia, nerve injury, pain, tiredness, and other symptoms that are common when people have surgery.
• Abdominal symptoms like bloating, nausea, or having a bowel obstruction.

Potential mental or social risks after donating:

• Problems with how you feel about your body or what it looks like.
• Problems with depression or fear and stress.
• Feeling sad if the transplant recipient becomes ill or dies.
• Changes in our lifestyle because you donated an organ.

Potential money problems after donating:

• Paying for travel, short-term housing and child care, and not being paid while you were away or recovering from surgery. Some money may be available to help you with such non-medical donation-related costs.
• Having to pay for costs of lifelong follow-up visits.
• Losing your job or your income.
• Having a hard time finding a job in the future.
• Having a hard time getting, keeping or paying for health insurance, disability insurance and life insurance.
• Future health problems that may not be covered by the transplant recipient’s insurance.

Scheduling Surgery and Final Preparations

Following complete medical and psychosocial clearance, the donor will meet with the surgeon.  After review of the CTU, the surgeon will discuss the techniques that can be used.  Together, the donor and surgeon will determine which procedure will be performed to remove the kidney. 

Now that the donor has been cleared medically and the surgical procedure has been determined, the surgery date for donor and recipient can be scheduled.  Because it is a scheduled procedure, the donor and recipient can work out a time that is convenient to them, their families and their obligations in accordance with the surgeons’ schedule availability.

During this final stage, many emotions may surface for both the donor and recipient.  It is not unusual to feel a range of emotions from elation to concern.  The support of family and close friends is very important throughout the preparations for surgery, donation, and recovery.

In the final weeks before surgery, the donor and recipient will be scheduled to see the members of the team in clinic to make final arrangements for surgery.  Some tests will be repeated for final confirmation, such as EKG, chest x-ray, and routine laboratory work.  The blood types and crossmatch will be repeated and confirmed.  The donor will have an appointment with the nephrologist to have final questions answered.  The donor coordinator will provide diet instruction and information about hospital admission.