Outlined below are some of the tests and procedures involved in the donation process. Should you decide to take the next step and contact your local Living Donor Transplant Co-ordinator, they will take you through each stage step by step and answer any questions/concerns you may have.
How you start the process:
Simply contact your local Living Donor Transplant Co-ordinator or Specialist Nurse – the more information you have the better. You can find contact details here.
Speak with your family
Consider the practicalities – e.g. you will need time off work and home arrangements may have to be considered
As a potential living kidney donor, you will require a number of tests to check you are suitable. We realise that you have a busy life and try to keep hospital visits to a minimum, however, ensuring your short and long term safety is our priority. On average the assessment process can take 3 -6 months, but this can be vary depending on your test results.
In Scotland there are two transplant units specialising in living donor kidney transplantation, in Edinburgh and Glasgow. In many circumstances the testing can begin in a unit close to your home, and you will be referred to the transplant unit at an appropriate time. We will liaise with your General Practitioner from the start of the process.
During the assessment process there are a number of different health professionals you will meet. Usually the first person will be a Living Donor Transplant Co-ordinator or Specialist Nurse who will guide you through the process and be a point of contact. Other healthcare professionals include:
Nephrologist (a specialist kidney doctor)
Independent Assessor – a person acting on behalf of the Human Tissue Authority
Clinic and ward nurses and doctors
There are lots of people behind the scenes – tissue typing specialists, laboratory staff, admin staff and the organ allocation organisation who work closely with the transplant team to ensure living donor transplantation is as successful as possible.
Most tests and investigations are standard throughout the UK, however each potential donor is unique and quite often extra tests are required to make sure it is safe to continue. If at any point you are advised that donation can’t proceed, as in any area of medicine, you are entitled to a second opinion and this can be arranged for you.
The tests include:
Blood pressure measurement
Blood tests – these blood tests can be repeated a couple of times, and check baseline liver and kidney function, blood sugar levels, haemoglobin levels and a check for virus or infections amongst other tests. Details will be discussed with you prior to testing. One of your blood tests is for your blood group and tissue type – essential to check the matching with the recipient.
Urine tests - you will usually be asked for a urine specimen at your clinic appointments.
Electrocardiography (ECG) - tracing of the electrical activity of the heart.
Isotope Glomerular Filtration measurement (GFR) - this test assesses the ability of the kidney to ‘clear’ the blood of a particular substance. It gives an overall measure of kidney function, allowing us to determine whether we can safely remove one and leave you with good kidney function for the rest of your life.
Differential kidney function scan (DMSA) - this test involves an injection of a radioisotope agent followed by a scan to assess the contribution of each individual kidney (split function) to the overall renal function.
Computerised Angiography (CT) - reveals the number and size of blood vessels taking blood to and from the kidneys, and shows detailed anatomy of the kidneys. This provides the surgeon with a ‘map’ of your kidney and helps decide which kidney is suitable to remove with minimal risk to you and to ensure safe transplantation in the recipient. This test is performed in the CT scanning department. Iodine containing “dye” is injected into a vein in the arm and the scan is performed. A computer is then used to build a 3-dimensional view of the kidneys and blood vessels.
All your test results will be discussed at a specialist team meeting. If the team are satisfied with the results and you are happy to continue, an appointment will be made with an Independent Assessor (IA). It is a legal requirement that approval is obtained from the Human Tissue Authority (HTA) prior to any living donor transplant in the United Kingdom. For further details about the HTA please visit www.hta.gov.uk.
Once this process is complete and satisfactory a date will be arranged for you to donate your kidney.
The process above may seem daunting and time consuming. However, our priority is always to ensure that donation is as safe as possible for the donor. Your Living Donor Transplant Co-ordinator will be there to support you throughout the process and answer any questions you may have. If you would like to find out more please get in touch.