The majority of the tests and investigations can be carried out in one day. Click for details of One day assessment for kidney donation. It is a busy day, starting at 8 o’clock in the morning and typically finishing mid-afternoon, but it saves multiple trips to the hospital for each individual investigation.
The day involves urine and blood tests, several scans, a chest X-ray and heart tracing and a meeting with the consultant in the afternoon. A lot of people find it helpful to have someone with them for company and to also hear what is being discussed. We ask that you do not have anything to eat from midnight the night before and only drink clear fluids (no tea / coffee / juice) until the first blood tests are completed. We’ll provide some breakfast immediately thereafter!
Some of your results will be available by the time you see the consultant in the afternoon, and the bulk of the other investigations are reported within a few days. The doctor will write a letter which will be sent to your friend / relative’s consultant – this is to allow them to make plans for transplantation or for dialysis if there is likely to be a delay. The details of the letter will NOT be shared with your friend / relative. You and your GP will also receive a copy of the letter. Although it is medically written, it mirrors what has been discussed with you on the afternoon of the 1-day assessment. If you ever get a letter and are uncertain as to what part of it means, please do not hesitate to phone. Likewise, if there are any of the scans that turn up something surprising or that needs further investigation, then we will phone you to let you know.
Living kidney donation is very much a joint project and we realise that you are the most important part of it! Our aim is therefore openness, transparency, and that you know the results and conclusions virtually as soon as we do.
Meeting of the live donor team
There is a combined meeting of those involved in the living donor transplant programme every 2 to 4 weeks, and once your investigations are complete we will discuss your assessment and review your scans together. This allows the surgical team to give careful consideration to your suitability. We also consider your friend / relative that needs a kidney at this meeting. A summary of the discussions is detailed in a letter and again you will receive a copy of this.
Once the living donor team has reviewed all the information about you, and considered that you are suitable to be a kidney donor, it is very important for you to meet the transplant surgeon to discuss the transplant operation. They will give you detailed information and be happy to answer the questions you will have about the surgery and recovery.
Occasionally the surgeon will realise that there is something additional that he/she would like to have checked before they will proceed with your operation, but since your case has been discussed and reviewed by the living donor team, typically extra tests are not required at this stage.
There are some other people that we would like you to meet before you actually donate. Often we can arrange for you to see them when you are coming to the hospital anyway to minimise the number of visits that are required.
- Education nurses – these are specialist nurses that are experienced in discussing the physical and emotional impact of what happens when you donate. Most of the information you will have heard before, but some of it may be new. It gives opportunity for discussion about any concerns, anxieties or questions that it is very common for potential donors to have.
- Independent assessor – this is someone who is not involved in the assessment or care of potential donors or recipients. They have been trained in the legal aspects of organ donation, and no living donor transplant can take place unless they are satisfied that donors are not being forced or paid to donate.
- Psychologist – it is a requirement for all those who are considering giving a kidney to a stranger to have a chat with a psychologist. Occasionally other possible live kidney donors find this useful too. We have an excellent psychology team who are experienced in live kidney donation. This assessment is often helpful in making sure that we have prepared the donor in the best way possible before they go ahead with donating a kidney to someone else.
The majority of the investigations will only have to be done once but it will be necessary to repeat some of the initial blood and urine tests before the operation. The “cross-match” test (which mixes your blood with your friend / relative’s blood to make sure there is no reaction and it is safe to proceed) has to be repeated within a couple of weeks of the operation.
The process above may seem daunting and time consuming! However, while our priority is always to make sure donation is as safe as possible for the donor, we can actually complete all of this within 2-3 months if necessary.
It is important that potential donors are aware that regardless of what stage they are in the process they can withdraw if they change their minds. The team will always support you in your decision and it will remain confidential.