What to Expect During a Living Donor Evaluation

If you're currently awaiting a liver or kidney transplant, you're likely familiar with the concept of living donor transplants. Perhaps you're even fortunate enough to have someone in your life who is willing to selflessly donate an organ to you.

Living organ donation is a remarkable act of generosity and courage. By receiving an organ from a living donor, not only can you significantly reduce your waiting time, but it also alleviates the pressure on the national waiting list, benefitting others in need.

Regrettably, many people remain unaware of the option of living organ donation. To raise awareness and understanding, we have a valuable living donation Q&A session featuring Living Donor Coordinator Kay Kosberg, R.N. from our Rochester, Minnesota campus. We kindly request you to share this information with those around you, as it covers a crucial first step in the living donation process - the donor evaluation. Together, let's increase awareness and promote the understanding of living organ donation.

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 a paired 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.

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 differences for kidney and liver donors, but generally speaking, if a person interested in donating has a history of certain kidney disorders, uncontrolled high blood pressure, diabetes, recent cancers, heart disease, liver disease, lung disease, colon disorders, nerve problems or unstable 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 be asked to complete lab and/or urine testing which would identify compatibility and if you meet screening criteria to be a donor.  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 start the donor evaluation.   Liver evaluations are conducted at Phoenix, AZ and Rochester, MN sites. Kidney evaluations can be completed at all three of the Mayo sites, in Rochester, MN; Phoenix, AZ; or Jacksonville, FL. Another option for kidney evaluation and surgery is remote donation at a transplant center closer to your home.  This may eliminate financial hurdles such as travel and lodging expenses and lessen caregiver burden. More information available with the living donor coordinator at any Mayo site.

What do the full evaluations entail?

The evaluations are two to four days of outpatient testing which ultimately covers head-to-toe health.  Some of these appointments may be completed by virtual consult.  Each person’s schedule may vary based on their situation, but some tests that may take place include imaging, such as CT or MRI, lab work, chest x-ray, or echocardiogram. Age-appropriate cancer screenings, such as, pap smear or colonoscopy should be completed with your primary care provider.  This will save time needed at Mayo Clinic. 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 and a water bottle 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.
• Connect with others in the transplant discussion group on Mayo Clinic Connect
• View our transplant toolkits on Mayo Clinic Connect