After completing an online questionnaire from their living donor transplant program to assess basic health, potential donors go through an evaluation that includes consultations with the donor team.
Living donors also go through both a psychosocial and a medical evaluation.
Psychosocial evaluations are performed by a psychiatrist, psychologist, or social worker, covering issues such as one’s motivation to donate, the donor’s awareness of risks, availability of support during recovery, and how one’s finances and health insurance might be affected. It’s important to have a caregiver attend this portion of the evaluation, as they will also be learning their role in supporting the donor, says Jennica Kim, living donor specialist at NewYork-Presbyterian’s Center for Liver Disease and Transplantation.
It’s also recommended to disclose your plan to be a donor to your employer to understand how they will handle your absence and whether you have vacation time or qualify for the Family and Medical Leave Act.
“Let them know your intentions,” says Kim, “and make sure you have that time available and you’re not going to go into financial hardship due to the donation.”
At this stage, team members will evaluate whether potential donors are eligible to receive any financial assistance.
Medical evaluations include disclosing general medical history before undergoing a number of tests, depending on the type of donation. Testing can include:
- Pre-cancer screenings
- Blood and urine samples
- Nuclear medicine test to measure kidney function
- Chest X-ray to check lung functionality
- EKG or stress test to measure heart function
- CT scan of the abdomen and pelvis
- Other exams depending on medical history and overall health
Living kidney donors, for example, undergo immunological testing (blood type and cross-match compatibility), metabolic-focused testing (to look for issues such as diabetes or high cholesterol), anatomic assessment of the kidneys and their blood flow, and screening for transmissible diseases (such as HIV and hepatitis).
Liver donors, says Kim, receive an abdominal MRI where the surgeon looks at their liver’s anatomy and fat content and determines if their liver size and split are appropriate.