Qualifications for Living Donors
In order to qualify as a living donor, an individual must be:
* Physically fit
* Good general health
* Free from high blood pressure, diabetes, cancer, kidney disease, and heart disease
* Between 18-60 years of age
* Gender and race are NOT factors in determining a successful match
The living donor must first undergo a blood test to determine blood type compatibility with the recipient.
Blood Type Compatibility Chart
Recipient’s Blood Type Donor’s Blood Type
O — O
A — A or O
B — B or O
AB — A,B, AB or O
If the donor and recipient have compatible blood types, the donor undergoes a medical history review and a complete physical examination.
The following tests may be performed:
Tissue Typing: the donor’s blood is drawn for tissue typing of the white blood cells.
Cross-matching: a blood test is done before the transplant to see if the potential recipient will react to the donor organ. If the cross-match is “positive,” then the donor and patient are incompatible. If the cross-match is “negative,” then the transplant may proceed. Cross-matching is routinely performed for kidney and pancreas transplants.
Antibody Screen: an antibody is a protein substance made by the body’s immune system in response to an antigen (a foreign substance; for example, a transplanted organ, blood transfusion, virus, or pregnancy). Because the antibodies attack the transplanted organ, the antibody screen tests for panel reactive antibody (PRA). The white blood cells of the donor and the serum of the recipient are mixed to see if there are antibodies in the recipient that react with the antigens of the donor.
Urine Tests: In the case of a kidney donation, urine samples are collected for 24 hours to assess the donor’s kidney function.
X-rays: A chest X-ray and an electrocardiogram (EKG) are performed to screen the donor for heart and lung disease.
Arteriogram: This final set of tests involves injecting a liquid that is visible under X-ray into the blood vessels to view the organ to be donated. This procedure is usually done on an outpatient basis, but in some cases it may require an overnight hospital stay.
Psychiatric and/or Psychological Evaluation: The donor and the recipient may undergo a psychiatric and/or psychological evaluation.
The decision to become a living donor is a voluntary one, and the donor may change his or her mind at any time during the process. The donor’s decision and reasons are kept confidential.
Risks Involved in Living Donation
All patients experience some pain and discomfort after an operation. And as with any major operation, there are risks involved. It is possible for liver donors to develop infections or bleeding, and or the liver may be injured.Living donation may also have long-term risks that may not be apparent in the short term. It is therefore important that the benefits to both donor and recipient outweigh the risks associated with the donation and transplantation of the living donor organ. In addition to potential individual health concerns, it is possible for negative psychological consequences to result from living donation. Living donors may feel pressured by their families into donating an organ and guilty if they are reluctant to go through with the procedure. Feelings of resentment may also occur if the recipient rejects the donated organ. Living donors must be made aware of the physical and psychological risks involved before they consent to donate an organ. They should discuss their feelings, questions and concerns with a transplant professional and/or social worker.Positive Aspects of Living DonationLiving donation has several advantages:
Living donation eliminates the recipient’s need for placement on the national waiting list. Transplant surgery can be scheduled at a mutually-agreed upon time rather than performed as an emergency operation. Because the operation can be scheduled in advance, the recipient may begin taking immuno-suppressant drugs two days before the operation. This decreases the risk of organ rejection.
Transplants from living donors are often more successful, because there is a better tissue match between the living donor and the recipient. This higher rate of compatibility also decreases the risk of organ rejection.
Perhaps the most important aspect of living donation is the psychological benefit. The recipient can experience positive feelings knowing that the gift came from a loved one or a caring stranger. The donor experiences the satisfaction of knowing that he or she has contributed to the improved health of the recipient.