Can I be a kidney donor?
Any normal, healthy adult with two normal kidneys can be a kidney donor. Your blood type will be the main factor in determining who can receive your kidney.
What blood tests are performed to determine if I am a compatible kidney donor?
ABO blood type
First, a simple blood test is performed to determine your blood type and that of the recipient. Here’s how your blood type should be compatible with the recipient’s blood type:
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If you have blood type A, your recipient should have blood type A or AB.
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If you have blood type B, your recipient should have blood type B or AB.
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If you have blood type AB, your recipient must have blood type AB.
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If you have blood type O, you are a universal donor and can donate to someone of any blood type: A, B, AB or O.
Tissue typing
Tissue typing is a blood test that evaluates the compatibility or closeness between your tissues and the recipient’s. A human lymphocyte antigen (HLA) blood test is used to determine tissue type and help ensure that you’re a good genetic match for the recipient. In an HLA blood test, the tissue typing lab can identify and compare information about you and your recipient’s antigens (the "markers" in cells that stimulate antibody production) so they can match your kidney to the recipient.
While siblings (brothers and sisters) have the best chance of being a perfect match (6 of 6 antigens), advancements in anti-rejection medications have greatly reduced the occurrence of rejection in kidneys from unrelated donors. Researchers are also making strides in the development of treatments, which will significantly increase the donor success rate when tissue doesn’t closely match.
Crossmatching
In crossmatching, your blood and the recipient’s blood are placed together in a test tube and examined to see if there is cell damage. If all your cells survive, there is a negative crossmatch, which is considered a good result. If your cells begin to die, a positive crossmatch results and you are disqualified as a donor. This gives a preview of what might happen with a transplant.
After the blood tests, how will I be evaluated as a potential donor?
If the initial blood tests indicate that you are a suitable match, we will arrange an extensive pre-transplant donor evaluation to ensure you are in normal physical and emotional condition and to inform you about the risks and procedures of being a kidney donor. The evaluation generally consists of three days of outpatient testing. Before the first evaluation appointment, you will receive instructions on collecting a 24-hour urine specimen to bring to the appointment. You also will be instructed to fast the night before the first appointment.
Day one
The first day of the pre-transplant donor evaluation, you will have a complete medical examination, a review of your medical records and a meeting with a nephrologist (kidney specialist). Tests will include:
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Blood work
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A glucose test to rule out diabetes
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A glomerular filtration (GFR) test, which determines the level of your kidney function
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An electrocardiogram (EKG), which charts your heart’s electrical activity to make sure there won’t be any complications during surgery
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You will have a consultation with a social worker
Day two
On day two you will have:
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A 3-dimensional CAT scan to examine your kidneys to determine if there are any defects that may put you at risk for donor surgery
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Chest X-ray
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A surgical consult to make sure you are in suitable physical condition to have a renal angiogram, the last of the standard pre-transplant donor tests. Your surgeon also will address your suitability for a laparoscopic donor nephrectomy
Day three
On day three you will have:
renal angiogram. During angiography, a long slender tube called a catheter is inserted into a large artery (generally in the groin area) through a small incision. A radiologist will inject a contrast material (dye) into the artery, which enables the blood vessels to appear on X-rays. The renal angiogram allows the transplant team to determine if there are any abnormalities in the kidney’s blood vessels.
At any time during the pre-transplant donor evaluation, please ask any questions you might have.
Additional tests for women
Pap test
A pap test is a routine test in which a sample is taken from the uterine wall to check for abnormalities, such as pre-cancerous cells.
Mammogram
A mammogram is an X-ray of the breasts to detect abnormal growths or changes, or to provide a baseline reference for later comparison.
Test results
Your test results will be compiled and evaluated in about two weeks. Once all the test results are in and the information is reviewed, the Renal Transplant Team will decide if you are a suitable donor or if you will need any additional tests after your pre-transplant donor evaluation. The transplant coordinator will be in touch with you to discuss your test results and answer any further questions you may have.
If additional testing is ordered, it can be performed at The Cleveland Clinic Foundation or in your home community. Your transplant coordinator will assist you with these arrangements.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/22/2004
