Are you considering donating a kidney? Well, that’s only a great first step. Before the kidney transplant, you need to undergo examinations and tests to ascertain that you are in good health, you are emotionally and physically ready to donate and your kidneys are working well. Your safety is the number one priority for the medics. Then how is the donor kidney tested?

How Is the Donor Kidney Tested to See Whether It Is Suitable?

1.     Primary Examination

Physical examination and review of medical history are done to see if there are any significant abnormalities before going on to other tests.

2.     Immunological Tests

A sample of the donor’s blood will be drawn to carry out tests as follows:

• Blood Type
  Blood type is the most fundamental transplant compatibility condition. It is determined as the following table.

• Human Leukocyte Antigens (HLAs)
  Human cells have six human leukocyte antigens, inherited half-half from both parents. For this reason, a match is more likely between family members. But donations can be made without complete HLAs match, provided there is blood type compatibility.
• Cross-Match Antigens
  Cross-matching involves mixing small samples of blood from the potential recipient and the potential donor to see if they will react. Where there is no reaction, the result is a negative cross match, which means the transplant can be done.

3.     Laboratory Tests

They will be conducted on a sample of the potential donor’s blood for:

• Assessment of kidney function, ease of clotting and hemoglobin system
• Screening for pancreatitis, liver disease, hepatitis B, venereal diseases and HIV
• Screening for electrolyte balance issues and glucose intolerance that may occur after transplant
• Look for possible viral activity
• In case a donor has CMV (cytomegalovirus), a kidney recipient may require medication after transplant for prevention of CMV reactivation.

4.     EKG 

How is the donor kidney tested to see whether it is suitable? This is a necessary test.

• An EKG (electrocardiogram) will be done for heart health assessment. 
• An X-ray may also be done to identify any abnormalities in the lungs.

5.     Blood Pressure Monitoring

Your blood pressure will be checked a number of times to determine whether it is normal or not. A donor with high blood pressure may be unsuitable because hypertension can cause kidney damage. Transplanting a kidney from such a person may expose the donor to an increased danger of damage to the remaining kidney.

6.     Kidney Function Tests

They are done on urine to:

• Test for any urinary tract infections (UTIs)
• Test for kidney abnormalities
• Assess the glomerular filtration rate (GFR) or the kidneys’ rate of filtering or clearing a substance.
• Determine how much protein is excreted within 24 hours. High protein secretion will require further evaluation.

7.     Intravenous Pyelography Test

The test injects dye into arm veins, which circulates around the body. Then X-rays are used to detect the structures of veins, arteries, ureter, kidney and others.

8.     Helical CT Scan

Helical CT scan may be done to assess the kidney’s internal status, including identifying any cysts, tumors or other abnormalities. 

Renal arteriogram may be done in case an abnormality is found from the helical CT scan. The test requires post-examination observation of up to eight hours and may necessitate hospitalization. 

9.     Special Tests for Female Donors

Female potential donors may undergo mammography and gynecological exams.

10.     Psychological Evaluation

How is the donor kidney tested to see whether it is suitable? Besides physical and physiological tests, other steps involve psychological evaluation. Its aim is to:

• Understand the motivation of a donor.
• Provide the donor with transplant information and emotional support.
• Provide an interface between staff, donor and the family for the period before, during and after transplant.
• Find information on any financial inducement or family pressure.
• Provide the donor with a more relaxed and less intimidating setting to ask for more information and to express any reservations.

In the event that the donor is hesitant or not willing to proceed, the team can assist the donor to decline without causing hurt in the family.

The Final Result

The tests may take several months. Once you have undergone all the examinations and tests, the kidney transplant team will make a decision on your suitability as a kidney donor. When you receive the transplant team’s evaluation results, you may decide to proceed.

On the other hand, if the transplant team finds you unsuitable as a living donor, it will inform the recipient. The details on why you are unsuitable will not be shared with the recipient unless you authorize it.

Who Can Be a Living Kidney Donor?

The question "how is the donor kidney tested to see whether it is suitable" has been answered. Following are the requirements for a living kidney donor who:

• Is aged between 18 and around 70
• Is interested in donating
• Has a blood type that is compatible with that of the recipient
• Enjoys good health
• May be a parent, child, sibling, relative or friend

In normal circumstances, you are not qualified to donate if you have any of the following conditions:

• Kidney disease
• Diabetes
• Cancer
• Sickle cell disease
• Heart disease
• Liver disease
• Hepatitis
• HIV