This phase involves a visit to your family doctor, filling out a questionnaire and having a tissue typing test.
Visiting your family doctor
Once you have told the transplant coordinator that you want to go ahead with the donation, you should make an appointment with your family doctor. Tell them about your plan to become a living kidney donor. Your family doctor will get a letter outlining the testing you need. Your doctor may have already done some of these tests in the past 12 months. The tests include blood and urine tests, and two 24-hour urine collections. Women will need a pap test, a breast exam, and possibly a mammogram. If you are over 50, you may need to give stool samples. You may also need a tuberculosis (TB) skin test.
The questionnaire will ask about your medical, social and travel history. You will get it in the mail. You can give it to the transplant coordinator.
Tissue Typing Test
All the donor needs to do is give a blood sample. The lab will work hard all day with your sample to see whether or not you are compatible match with your recipient. The lab will look at antigens called human leukocyte antigens, or HLA. There are six HLA tested for each person. You get 3 from your mother and 3 from your father. Though it is better to have matching HLAs with the recipient, is not necessary for the transplant.
Cross match test
This blood test is performed at the same time as the tissue typing test. It will find out if the recipient is likely to have a reaction to the donor kidney. The white blood cells from the donor are mixed with blood from the recipient. If the recipient’s blood cells attack and kill the donor’s blood cells, it is called a “positive cross match”. This means the donor and recipient are not compatible and the recipient’s body is likely to reject the kidney. If the donor’s cells are not killed then the result is a “negative cross match” and the pair is compatible. A negative cross match means that the recipient’s body is less likely to reject the kidney.
It is important that you arrive on time for this test. The lab needs to get your sample early so they have time to do all the tests while the blood is still fresh. The tests take a long time. The donor coordinator will schedule the tissue typing test and tell you the date.
If you find out you are not compatible with the recipient you had chosen, the transplant coordinator will discuss the Living Donor Paired Exchange Registry with you.
If you and the recipient are compatible, you will go on to Phase II of the evaluations.