Becoming a Kidney Donor

Donor Evaluation

At Beaumont Hospitals, the confidential organ donor process begins with a telephone interview to cover your medical history. We will send you a donor booklet, a general consent to treatment form and a donor questionnaire. After you return the questionnaire, a Beaumont transplant nurse coordinator will contact you, and appointments will be made for physician interviews, physical exams and blood tests.

If you do not live in southeast Michigan, the transplant coordinator will help arrange to have the blood drawn where you live. If testing reveals that you would not be an appropriate donor, the person you wish to donate will have alternative therapy available.

A donor is a volunteer who is making a generous gift to someone who needs it. Donating a kidney should not increase your risk of kidney failure or shorten your life expectancy. Nevertheless, you'll be left with one kidney. If that kidney is injured or develops disease, its function would be at risk.

Donation may also affect your ability to obtain health, disability or life insurance. If you are uncomfortable about donating, you can opt out, and your reason will remain confidential.

Blood Testing

This test determines your blood type. It must be compatible with the recipient's.

Tissue Typing

This blood test reveals how many genetic similarities you and the recipient have. Antigens are important for transplant success. The ideal match is an identical twin. Next best is a living-related, six-antigen match. Overall, despite the match, a kidney from a living donor is significantly better than one from a deceased donor.

Crossmatch

A crossmatch provides information about the risk of immediate, severe rejection if the kidney is transplanted. The recipient's blood is mixed with lymphocytes (white cells) of the donor's blood. There must be no reaction between the two samples for a kidney to be considered for transplant. Overall, despite a zero match, we would proceed with a antigen match kidney which is successful.

Choosing the Donor

When all interested parties have been tested as possible donors, one will be identified as the kidney donor of choice. If that donor is unable to continue the evaluation, another will be chosen. Many things are considered beyond the initial blood testing. Your nurse coordinator will discuss these with you. Write down any questions you have for the nurse coordinator; now is the time to talk about any issues on your mind. If you don't live in Michigan, your transplant nurse coordinator will make arrangements with the closest transplant facility in your area for all testing except the spiral CAT scan. You'll meet the Beaumont multi-disciplinary transplantation team members including the transplant surgeon, transplant nephrologist, transplant nurse coordinator, transplant Social Work and Financial Coordinator as well as your Independent Donor Advocate before the surgery date. Your coordinator will give you the details.

Length of Donor Evaluation Phase

The time it takes to complete the tests depends on you and your schedule. Testing is arranged at your convenience, when possible. Because the tests must be performed in a certain sequence, some of them cannot be grouped. Your transplant nurse coordinator will help you. It is essential that you stay in contact with your nurse coordinator.

Medical Evaluation

To qualify as a potential kidney donor, you must be in good health. During the donor evaluation, each transplant team member will conduct his or her part of a thorough surgical physical and mental health history, as well as a physical exam. The transplant team must be certain you do not have significant risk factors for this elective surgery. The transplant team makes the final decision about whether you can continue.

Surgery

There are two surgical techniques for living-donor kidney removal - open and laparoscopic. Although laparoscopy has become common for donor surgery, both techniques have their place, and both are used at Beaumont. The final decision as to which technique will be used is based on many factors, especially the internal anatomy of the donor.

Laparoscopic Donor Surgery

This technique uses two or three ½-inch incisions through which a laparoscope and other instruments are placed into the abdomen to perform surgery. To remove the kidney, a three-inch incision is used. Benefits include reduced blood loss, quicker recovery, a shortened hospital stay, and greater magnification for the surgeon.

After Surgery

You will go to the recovery room as the anesthesia slowly wears off. You will feel tired. You will have blood pressure, pulse, temperature, urine and dressing, inscision checks. Also, you will receive pain medication. When you're ready, you'll be transferred to the surgical nursing floor. Laparoscopic procedures usually require a one to two day hospital stay, whereas open procedures require two to five days. When you are discharged, you should be able to care for yourself. Pain should be manageable with oral pain medications taken for one to two weeks. Full healing of your incisions will probably take at least six weeks. Your physician will counsel you on appropriate activities. You will have the opportunity to discuss everything in detail with your surgeon.