Kidney transplant surgery

Potential living donors can accompany the intended recipient to their evaluation with the nephrologist or surgeon, provided both parties are comfortable. If the potential donors meet the minimum requirements for donation, they may undergo initial lab work to test for compatibility on the same day as the recipient's evaluation. This visit is also an excellent opportunity to discuss the kidney donation process in detail with the potential donor.

For potential donors living at a distance, initial testing can often be completed near their home. They can then travel to San Diego for the remainder of the evaluation and surgery. It's important to talk to your coordinator about specific arrangements. Once lab test results are received, the Sharp Kidney Transplant team will determine the best-suited donor based on genetic match, health and willingness.

The selected donor will undergo medical and psychosocial evaluations. If approved, surgery will be scheduled. It may be necessary to evaluate several potential donors before identifying a suitable match.

Initial evaluation: The first step involves determining if the potential donor is physically healthy to donate. This includes evaluations with different members of the transplant team, lab testing, imaging and other diagnostic tests. Compatibility testing with the intended recipient is conducted once the donor is deemed a suitable candidate.

Medical testing: Potential living donors will undergo several tests, including:

• Blood and urine testing

• A chest X-ray and CT scan

• An EKG or electrocardiogram

• Donors over 50 or those with specific indications may also undergo a cardiac stress test

Cancer screenings: Donors need to be up to date on these cancer screenings:

• Pap smear for women over 20

• Mammogram for women over 40

• Colonoscopy for donors over 50

If donors need to complete these screenings, coordination with their primary care provider is necessary.

Additional testing: The nephrologist or surgeon may request further tests. Abnormal results may require referral to the donor’s doctor for evaluation and follow-up.

Medical fees related to living kidney donation are typically covered by the recipient’s health insurance. However, donors may incur some non-medical expenses related to the donation process. These can include:

• lost wages due to time off from work for testing and surgical recovery, which generally requires about 3 to 4 weeks, depending on job duties

• travel and housing expenses if they do not reside in the area where the donation takes place

Financial assistance is available for donor costs through programs like Donor Shield, which may cover housing, travel expenses and lost wages, if the donor meets certain qualifications. It's important to discuss this with the transplant coordinator to determine eligibility.

Donors must maintain their own health insurance for any follow-up required due to abnormal results found during the evaluation. They are also encouraged to continue regular follow-ups with their primary care provider post-donation. It is against the law to provide any form of financial compensation for living kidney donation.

During the donor evaluation process, our center assesses the donor's blood type, tissue type, and conducts a crossmatch test to determine if a donor is a suitable match for the recipient. If compatibility is confirmed, direct donation becomes an option.

Sharp Kidney Transplant is part of the Living Donor Kidney Exchange Program through the National Kidney Registry (NKR). Sometimes, patients arrive with donors who are incompatible. The Living Donor Kidney Exchange Program facilitates the matching and exchange of kidneys between compatible parties. If a living donor is not a match for their intended recipient, alternative donation methods are available:

• Paired kidney exchange: This involves matching incompatible donor/recipient pairs with others in similar situations. Matches are made within our center and with other transplant centers nationwide. Donor kidneys may be transported to corresponding hospitals, or donors may travel. This is discussed during the initial education session and upon finding a match.

• Voucher donation: This allows a donor to give their kidney before the recipient's transplant. It can reduce waiting time compared to a paired exchange and enables the donor to recover before potentially acting as a caregiver post-transplant.

We are responsible for ensuring that you are well-informed about your decision to donate. We need to be sure you are aware of all the potential risks and benefits of donation. Education is also a very important part of this process. We want you to know your health and well-being is as much of a concern for us as the recipient's health and well-being.

The following is a list of some of the information that will be reviewed with you.

• The fact that we will be in contact with you over the two years after your donation to collect data that we are required to provide to the United Network for Organ Sharing (UNOS).

• The potential recipient's medical options other than transplant.

• There are some potential medical, financial and psychosocial risks associated with donation. These will be discussed with you on an individual basis in your appointments at the transplant center.

• The type of surgery that will be performed, how long you will be in the hospital and what the typical follow-up after surgery will be.

• This is a process. There will be many tests done to ensure that you are safe to donate. A surgery will not be planned until the majority of the testing is completed.

• You may at any time in the process decide not to donate.

• You understand that this is a completely confidential process. We cannot discuss your results with anyone else unless you give us permission to do so.