How To Determine Kidney Donor Match

What Processes Do You Have To Go Through To Be A Living Kidney Donor

The decision to donate a kidney is just the first step on a journey that may eventually lead to a kidney transplant operation.

Everyone who wants to donate is asked to go through a number of tests and examinations. These checks are designed to ensure that you are healthy enough to give a kidney, that your kidneys are currently working well and that you are physically and emotionally prepared for the donation. Your safety and well-being is always the priority for the medical teams and you should be aware from the beginning that there may be a number of reasons why you might not be suitable to donate. The tests and checks can take several months , which include medical, surgical and psychological assessments.

In England, Wales and Northern Ireland, no minimum age limit is specified under the Human Tissue Act 2004, but most donors will be over the age of 18 years. In Scotland, the law specifies that the donor has to be over 16. There is no upper age limit, and there have been donors in their 70s and 80s.

Throughout the process, anonymity and confidentiality are necessary, and most altruistic donors never meet the person who receives their donated kidney. It is, however, possible for both parties to contact each other after the transplantation, but only if both parties are willing.

Tests and examinations before the operation

General physical health

Psychological health

Urine tests

Blood tests

Glucose tolerance test

Blood pressure monitoring

Kidney tests

ECG

Chest X-ray

How Are Donor/recipient Pairs Matched

For many years, matching potential donor/recipient pairs was managed through the local hospital, or through partnering with area hospitals. Recently, The Organ Procurement and Transplantation Network started a Kidney Paired Donation program that will find matching donor/recipient pairs throughout the United States. Johns Hopkins experts anticipate that, each year, an additional 1,000 2,000 donations can be performed through this national program.

It Took About 16 Months From The First Appointment To Surgery Di Never Really Knew Which Test

Did you ever kind of think, Oh, why am I doing this?No.During that time?No, never. If it had taken three years Id have carried on doing it. I just wished that Id been given a bit more information and knew what to expect. I mean if you know that youve got to wait two months for your next appointment, you wait two months. But when you dont know and its week after week you dont hear a thing, then you start to begin to worry, Ive failed, Ive failed the tests, you know.And then of course you hear theres another appointment and you think, Oh thank goodness for that.

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Living Donor Kidney Transplants

Incompatible Living Donor Transplant | Paired Donor Exchange | Next Steps

The first successful live donor kidney transplant was performed in 1954. The donor and recipient were identical twins. Since then, our understanding of donor compatibility and the development of immunosuppressant medications have greatly advanced living donor procedures. Today, approximately 75% of people who receive a kidney transplant from a living donor maintain their kidney function for 10 to 20 years.

Living donor programs allow a relative or a compatible unrelated donor to donate a kidney. Siblings have a 25% chance of being an “exact match” for a living donor and a 50% chance of being a “half-match.” Donor compatibility is established through blood tests that look for matching blood types and antigens. The overall health of the potential donor is also of critical importance.

Kidneys from perfectly matched sibling donors on average can function for over 35 years. Live donor procedures of all types, however, offer better outcomes than deceased donor procedures:

• Live donor recipients spend less time waiting for a donor organ. The wait for a deceased donor kidney in New York averages five to seven years.
• Immediately upon transplantation, 97% of live donor kidneys are fully functional, versus 50-60% of deceased donor kidneys.
• Live donor recipients face less risk of organ rejection.

Transplant Procedure

Finding A Kidney Donor

Once your doctor has determined that youre a good candidate for a kidney transplant, youll need to be matched with a kidney donor who is compatible with you in tissue and blood type. There are several ways to go about finding a kidney donor.

Talk to family and close friends about kidney donation. Because youll need to find a compatible kidney donor, a blood relative may be your best matchthough a kidney could also come from a close friend, acquaintance, or co-worker. Talking openly about your donor search can help identify possible donors.

Place your name on the kidney transplant waiting list to receive a donor kidney. Even if you might find a donor on your own, its important to register on the donor list as a backup. With todays advanced donor-matching technology, its possible to find a good match with a living or deceased donor. For more information on how to get started, talk to your social worker.

Register for a paired kidney exchange program. If you have a potential donor who turns out not to be a match for you, a paired kidney exchange programsometimes called a kidney swapcan match pairs of recipients and their incompatible donors so that you each receive compatible kidneys.

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Blood Groups & Donor/recipient Compatibility For Kidney Transplantation

From this table, you will see that blood group O donor can be considered a universal donor i.e., they can give a kidney to anyone and blood group AB recipient is a universal recipient, i.e., they can receive a kidney from anyone.

These are important rules in the process of transplantation.

Once blood group compatibility has been confirmed, the donor has to be tested for tissue type compatibility. The tissue type of the donor and recipient will be determined in the tissue typing laboratory by way of a blood test. This process may take up to six weeks. The better the match between the recipient and the donor, the better the long-term success of kidney transplantation.

Your blood is tested for tissue markers called HLA antigens to determine your tissue type. Potential donors are tested for 6 different sets of markers, and you will be informed of how similar your tissue type is to the recipient. The best match is where all 6 sets of markers are identical, and these are referred to as a full house or zero mismatched graft.

Donor and recipient matching is important for two reasons. Firstly, because a better match often results in better success of the transplant. Poor matching can make kidney transplantation a second or third time much more difficult.

When testing donor and recipient compatibility, we have to avoid giving a patient a kidney to which he or she has formed antibodies, as this would result in the early failure of the donor kidney.

Evaluation Steps To Determine Donor Compatibility For Successful Kidney Transplants

Donor evaluation is one of the most important steps towards achieving a successful kidney transplant. Today, living kidney donors are on the increase as more and more people donate kidneys and give the gift of better health to those suffering with kidney disease. While before kidney donation was most often through a deceased donor, nowadays thousands of lives are saved each year, thanks to living kidney donations.

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Paired Kidney Donation Program

Many patients in need of a kidney transplant may have individuals in their lives willing to donate a kidney, but unfortunately their friends or loved ones cannot donate because they are not compatible. The Kidney Paired Donation program is offered to patients who have donors that do not match their blood type or who cannot accept a kidney from a donor because there is a strong chance they would reject the kidney. This type of kidney donation is called a “paired kidney exchange” or “kidney swap.” Visit our Paired Kidney Exchange page for more information about University of Michigan Transplant Center’s Paired Kidney Donation Program.

What Are The Steps For Kidney Donor Evaluation Process

The first step is the Initial Interview and if there is more than one potential donor, establishing compatibility. Potential donors should fill out the online questionnaire.

The second step is the assessment about your overall health status. A comprehensive medical history and physical examination is performed. It is very important that you declare all health-related history such as having high blood pressure, diabetes, kidney disease, kidney stones, stroke, heart and lung diseases and surgical interventions. You need to report your family history, especially family history of kidney diseases. A psychosocial assessment will be performed as well. History of smoking, drugs and alcohol needs to be discussed.

After the complete medical and psychosocial clearance is complete, the donor will meet with the surgeon to discuss the risks of donor surgery. Once the donor is fully cleared to proceed, the surgery date for the donor and recipient can be scheduled, at their convenience.

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How Do I Know If My Kidney Is A Match For The Recipient

The transplant team will check your blood type as well as the recipient blood type to see if they are compatible. A unique blood test also needs to be done which is called crossmatch.

It is possible that the recipient of the kidney has an allergy to the donated kidney so the recipient’s body may reject the donated kidney. Such allergy is due to some substances called antibodies which are present in the recipient’s blood. In order to make sure that the recipient does NOT have those antibodies against your kidney tissue, the crossmatch test is performed. Briefly, a sample of your blood is combined with a sample of the recipient’s blood. If the recipient has antibodies to the donor, this will cause a “positive” reactivity during the crossmatch test. This may mean your recipient is incompatible to you. In the case that you and your recipient are not compatible, you may participate in UCLA’s Kidney Exchange Program. This program allows the recipient and donor to enter a paired exchange registry, where the donor will donate to another recipient that is matched, and the recipient will recieve a matched kidney from a compatible donor in return.

Can You Live With One Kidney

• Living Kidney Donor Surgery
• 10 Things to Know About Living Kidney Donation

When most of us think about kidney donation, we think of checking a box on our drivers license in case of an accident. But you dont have to be deceased to donate a kidney. Being a living kidney donor is actually more commonand safethan you might think.

Living kidney donations save thousands of lives each year. What do you know about being a living kidney donor?

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You Dont Have To Be Related To Someone To Donate A Kidney To Them

In fact, one in four living organ donors is not biologically related to the recipient . Spouses, in-laws, close friends, church members, and even members of the same community can all be living donors.

It’s true that family members have a higher chance of being a good match. But living donor transplants are more successful compared to kidneys from deceased donors because these kidneys come from living donors.

Benefits Of Living Kidney Donations

Basically, there are two types of kidney donors, deceased and living. The rise in popularity of living kidney donors is because it has proved to be the best option for those needing a new kidney. It, to a large extent, eliminates the long waiting period, which can even stretch to years when on a national waiting list. Kidney donations are the most common living organ donations, with surgeries being performed since the 1950s.

Living kidney donations are safe and the donor can lead a normal life as the remaining kidney takes on the role of both, with ease, as surprisingly the body does not need two kidneys to function normally. Further, donating a kidney does not in any way increase the donorâs risk of getting kidney disease or any other health issues such as diabetes.

Thanks to the advancements in the medical field, the donors no longer needs to be related to the receiver, in order to donate. Today, one in four living organ donors are not biologically related to the recipient, which means that those in need of a new kidney have a higher chance at receiving one, quicker.

Living donations are divided into two categories:

Directed donations with specific recipient in mind and is usually between two known parties such as friends and relations

Non-directed donations no specific recipient named, instead the kidney is matched with someone in need

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The Independent Living Donor Advocate

All transplant programs are required to identify an independent living donor advocate to potential donors. This person promotes the best interest of the potential living donor, advocate for the rights of the potential living donor and assists the potential living donor in obtaining and understanding information regarding:

• The consent process
• The evaluation process
• The surgical procedure

The benefit and need for follow-up in six months, one year and two years after donation.

The ILDA and or the donor coordinator will contact you six months, one year and two years after donation to check on your well-being and to obtain basic information about your health.

Kidney Donation Process Overview

Contact the Transplant Center: Individuals who wish to be considered to donate a kidney must contact the Living Kidney Donation Program at to indicate their interest in donation. The Transplant Center cannot initiate contact with potential donors until they declare their interest. Potential donors will speak with a member of the living donor team who will begin the process by asking questions that include demographic information, personal and family general health history, medications and social history.

Blood Type Matching: Potential living donors are tested to determine blood type.

Tissue Typing: Potential donors who are medically eligible will need to have blood drawn for tissue typing. Tissue typing determines compatibility with the recipient. If the donor and recipient are not compatible, they may be eligible for our paired donation program. The paired kidney donation program is offered to patients who have donors that do not match their blood type or who cannot accept a kidney from a donor because there is a strong chance they would reject the kidney. The patient and donor are then paired with other patients and donors to find matches.

Living donors are free to confidentially withdraw at any time during the donation evaluation process and are not obligated to donate.

To learn more about testing and living donation or learn more with our living donor education booklet and .

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Kidney Offering And Matching

When an organ donor is notified to NHS Blood and Transplant the following details are recorded: their renal function, blood group, and tissue type. The donor information is then added to the national database which identifies the most suitable recipient for the kidney.

Suitability is determined by a complex mathematical process which gives priority based on the following factors, each of which are given points:

• The compatibility of the blood group
• Length of time on the waiting list one point for every day waiting
• The similarity of the donor and recipients tissue types the better the match the more the points
• Whether the recipients tissue type is unusual such that it would be particularly hard to find a transplant for that person. Difficult to match patients are awarded more points in order not to miss the rare chance of a transplant
• Whether the recipient has developed antibodies that reduce the likelihood of a match. This is called sensitisation highly sensitised patients get more points.
• The age of the recipient children get more priority

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What Are The Common Matching Factors

Blood type and body size factor into a match.

Other factors include:

• how bad the patients medical condition is
• the distance between the donor’s and the patients hospital
• the patient’s waiting time and
• if the patient is available. For example:
• If they cant contact the patient.
• If the patient has an infection or other reason that they cant do the transplant.

The most important factor is the organ itself. Some organs can survive outside the body longer.

Theres a different policy for each organ. Read about how the system decides who gets which organs.

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Testing Involved In The Living Donor Evaluation Process

The following process is used to determine if someone can be a donor. This is a general description of the testing process, and may vary from center to center:

A medical history review and physical examination. An extensive review of all systems, including previous illnesses and surgeries and past family medical history. Any abnormalities found are investigated further before invasive tests are performed.

A financial consultation will be used to determine financial and insurance coverage for the testing process and the donation itself. Generally, if the donation is to a family member or friend, the recipient’s insurance will pay for testing and surgery expenses. However, the donor might be responsible for travel expenses and follow-up care, in addition to lost wages. Since donors are never financially compensated, be sure to ask the financial counselor and/or social worker at the transplant center for assistance with these issues.

Immunological Tests: A blood sample is taken for the following tests:

ABO test to determine the donor’s blood type: O, A, B, or ABPlease note that there are some programs that may help donor/recipient pairs with blood types that are incompatible: paired exchange and plasmapheresis.

Family analysis: If an entire family is being tested, blood samples will be taken of all potential donors to determine compatibility. This takes approximately one week before the results are known.