What to Expect During a Living Donor Evaluation

If you’re currently waiting for a liver or kidney transplant, you’re most likely familiar with living donor transplant. Maybe you’re even planning to have one if there’s someone in your life generous enough to be your donor.

Living organ donation is an amazing act of generosity and courage. When a living person donates an organ, it not only shortens the waiting time for the person receiving the organ, but also reduces pressure on the national waiting list for others.

Unfortunately, many people don’t know about living organ donation. Here’s a helpful living donation Q&A with Living Donor Coordinators Lisa King, R.N. and Kay Kosberg, R.N. from our Rochester, Minnesota campus. Please consider sharing it with those around you to help us further awareness and understanding of living organ donation. This post covers an important first step in the living donation process – the donor evaluation.

If someone is interested in being a living organ donor, what’s the first thing they should do?

For anyone interested in being a living organ donor, we strongly recommend they take their time to research and think the decision through before committing. It may be helpful to talk with others in the transplant discussion group on Connect, or with family members, close friends, someone else who has considered donating an organ, a social worker or counselor. Here are some questions that might help the potential donor make their decision:

• How do I feel about donating?
• Can I afford to take the time off work to rest and recover after surgery?
• Do I know enough about the process to make an educated decision?
• How may the donation change my relationship with the person I am donating to?
• Are there current health concerns that might keep me from donating?
• Do I have support from family members or close friends to help me through this process?
• How will I feel if it is determined I am not able to donate?
• Am I willing to take part in an organ donation chain if I’m not a match with the person I wanted to donate to?
• What if the organ that I donate doesn’t work well? How would I deal with that?

At Mayo Clinic, you’ll have an Independent Living Donor Advocate to help you determine if organ donation is the right choice for you.

So if someone does their research and decides they’d like to move forward, then what?

The next step, after careful consideration, is taking our online Health History Questionnaire. It’s our way to evaluate whether an interested donor would meet the basic qualifications of donation. Be sure to set aside adequate time to complete the questionnaire, and we recommend using your desktop computer or laptop rather than your smart phone. When you submit the questionnaire, you’ll receive a confirmation email that it’s been received by our team. If there aren’t any health issues that disqualify you for being considered as a donor, you’ll be contacted by one of our nurses in the transplant center. If you do not qualify for donation, the form will provide you with a notice on the screen and will not allow you to proceed with the questions.

What are some basic criteria for living donors?

There are definitely nuances for kidney and liver donors, but generally speaking, if a person interested in donating has a history of kidney disease, uncontrolled high blood pressure, diabetes, cancers, heart disease, liver disease, lung disease, certain kidney disorders, colon disorders, nerve problems or psychiatric disorders, they may be ruled out as a living donor.

If a potential donor passes the Health History Questionnaire, what are next steps?

Next steps are that the potential donor would receive a phone call from one of our Living Donor R.N. Coordinators, and depending on that person’s questionnaire results, they may get a kit mailed to them to do some preliminary bloodwork and screening. This can be completed through the person’s local lab or primary care provider. If those tests indicate they would be a candidate for living organ donation, the next step is to travel to one of our sites in Rochester, MN; Phoenix, AZ; or Jacksonville, FL for a full evaluation.

What do the full evaluations entail?

The evaluations are three to four days of outpatient testing which ultimately covers head-to-toe health. Each person’s schedule may vary based on their situation, but some tests that may take place include imaging, lab work, chest x-rays, echocardiogram, cancer screenings, pap smear, colonoscopy, and others. The potential donor will also have meetings with the transplant team.

It sounds like a busy few days! Any advice for patients during the evaluation?

Yes! Wear comfortable clothes that are easy to get on and off, and good shoes. Pack healthy snacks to help keep your energy up. And yes, plan to be busy!

My other advice is to be prepared to experience different emotions during the evaluation. At the point of the evaluation, potential donors have done their research and put a lot of time and effort into preparing, but traveling and going through the evaluation makes the process feel very real. We remind potential donors that the decision is theirs and that they can change their mind at any time during the process with no questions asked. There is also a potential of being ruled out based on your evaluation results. This can be difficult for patients to be ruled out this close to the end of the process.

That’s a good reminder. What happens if someone changes their mind?

Their reasons are kept fully confidential, and the person still receives full support from our team in working through the change of plans. It’s a lot of pressure to carry the responsibility of a living donor. Many donors feel accountable for saving someone’s life, but there are alternatives and no one should ever consider being a living organ donor out of pressure or guilt. Alternatives for the person in need could be deceased organ donation, dialysis if the person needs a kidney, or they may even be able to find a different living donor. There are other ways to help for anyone who changes their mind, such as serving as the patient’s champion, coordinating meals or rides.

This is a surgery you don’t have to have, and we’re committed to looking out for the donor and recipient’s well-being.

Learn more by visiting our living donor toolkit.

HELPFUL LINKS

• Explore Mayo’s Transplant Center.
• Request an appointment.