Living Kidney Donor: Donation Process
The donor evaluation process is generally completed in four steps:
Step One includes: blood typing, tissue compatibility, and antigen matching. This step can be completed without coming to Georgia Regents Medical Center. Please read below for an explanation of Step One:
Determining the blood type of the donor
| If the Recipient is:
||The Donor must be:
| Type O
| Type A
||Type A or O
| Type B
||Type B or O, and in some cases, A
| Type AB
Type AB, A, B, or O
Determining tissue compatibility with the recipient
The test of tissue compatibility is called a “crossmatch.” It involves combining live white blood cells from the potential donor with the fluid part of the recipient’s blood, called the “serum.” Some recipients have special proteins in their blood that attack foreign cells. If the recipient’s serum kills your white blood cells, the crossmatch is called “positive.” This means there was positive killing of your cells. In this case, the transplant cannot be done. If the recipient’s serum does not kill your white blood cells, the crossmatch is called “negative.” This means that there was no killing of your cells. In this case, the transplant can be done because you and the recipient are compatible. If the crossmatch is negative then antigen matching is completed.
Matching of antigens
Human Leukocyte Antigens (HLA) are proteins on white blood cells. Each person has six different antigens. Three are inherited from each parent, making a total of six antigens. The six antigens of the donor are compared to the six antigens of the recipient, and the “match” is determined. You do not have to match any antigens with the recipient to be a suitable donor. The “crossmatch” is actually more important than the “antigen match.”
The results of your tissue typing and the results of the crossmatch will be called to you in approximately five days after your blood is received. After the results are discussed with you, you will have the option of continuing the evaluation. The results will not be disclosed to the recipient unless you have approved of the disclosure. If you wish to continue with the evaluation process, you will then undergo “Step Two” of the evaluation.
If it has been determined that you are incompatible with your recipient, the option of kidney paired donation may be presented.
Step Two includes: Blood and urine tests to evaluate your kidney function and overall health. This step can also be done without coming to Georgia Regents Medical Center. If you progress to “Step Two,” your coordinator will send a request for these tests and give you an authorization for Georgia Regents Medical Center's payment of these tests. After your lab results have been received and approved, you will be given the option of moving to the next step.
Step Three includes: X-rays of your chest and an EKG of your heart. These can also be done at your local hospital. Your coordinator will send the requests and authorization for payment. Once these results have been received and approved, you will be given the option of moving on to the next step.
Step Four includes:
A special X-ray called a CT scan of your abdomen and pelvis. This test must be done at Georgia Regents Medical Center. Your coordinator will schedule this test for you. The CT scan shows how your blood vessels are attached to your kidneys.
A visit with a donor nephrologist at Georgia Regents Medical Center. This is a doctor who will formally clear you as a potential donor. The donor nephrologist will go over all of the results of your testing and answer any other questions you may have.
A visit with the living donor advocate at Georgia Regents Medical Center.
After Step Four has been completed, your case will be discussed in a multidisciplinary meeting called “Donor Conference.” Donor Conference is generally held every other Thursday. The Donor Evaluation Committee consists of recipient and donor pre-transplant coordinators, recipient and donor transplant surgeons, donor advocate, donor nephrologist, and Georgia Regents Medical Center radiologist. The team will decide that you are either (1) Approved for donation, (2) Approved with additional testing needed, or (3) Denied for donation. Your transplant coordinator will contact you after Donor Conference to discuss your eligibility as a donor.