Kidney Donation: Screening and Selection


So you’ve decided to donate a kidney. Here’s what to expect from the donor selection and screening process.

Getting Started

To be a donor, you should be at least 18 years old. The best candidates don’t have any major illnesses, aren’t overweight, and don’t smoke. You may get the OK as long as you lose weight or agree to quit smoking before the surgery.

There are two types of donation:

Directed donation. Your kidney goes to a person that you choose. The team at the transplant center where the surgery will happen should walk you through the process.

Non-directed donation (also known as altruistic donation). Your kidney goes to a stranger who needs it most. To find out how to get started, contact the transplant center nearest you.

Tests and Evaluation

Before you can donate, your doctor will do some tests to make sure you and your kidney are healthy. The first thing they’ll do is check your blood. This is especially important in a directed donation to make sure your kidney is a match for the person who will receive it.

There are three main blood tests to check for compatibility between donor and recipient:

Blood type test. This makes sure your blood type and the recipient’s blood type are a good match.

Crossmatch test. Doctors mix a sample of your blood with a sample of the recipient’s to see how they react. This makes sure they don’t have antibodies that will cause their body to attack your kidney.

HLA typing. This looks to see if you and the recipient share certain genetic markers related to the immune system. A high match isn’t necessary, but it’s good for judging the outcome of the surgery.

Even if you are not a good match, you may still be able to donate a kidney. Depending on the transplant center, you may be able to participate in a paired donor exchange, or your intended recipient can get desensitized by removing antibodies directed against you. Each transplant center also has many other screening tests, usually involving:

More blood tests. These look for overall health, especially the health of your kidneys and liver.

Urine tests. These check the health of your kidneys.

Chest X-ray. This looks for lung or heart problems.

Kidney tests. You may get a CT or MRI of your kidneys to make sure both your kidneys are normal and healthy.

EKG. This makes sure your heart is in good condition.

Complete medical and psychological exam. This looks for any other issues that might affect your ability to donate.

A few medical conditions may stop you from donating a kidney. These include:

  • High blood pressure
  • Diabetes
  • Kidney disease
  • Liver disease
  • Heart disease
  • Cancer
  • Drug or alcohol abuse
  • HIV or hepatitis

Next Steps

You’ll hear back from the transplant team. It might be several weeks after testing before they let you know if you can donate your kidney.

Timing for surgery depends on many things. It’s up to the surgeon’s schedules, as well as what works for you. Remember that things may change depending on the recipient’s health.

In the weeks leading up to the surgery, you may also be called in for more tests.

Now that you have decided to donate, you may be impatient and want to get things going. Use this time to let the people who are important to you know what’s going on. Your transplant team will help you prepare for surgery and afterward. Be sure your friends and family members know what’s happening and will be there to support you.