If your medical history and physical shows you to be in generally good health and your blood type is compatible with the potential recipient, the transplant team will begin the process of assessing you as a potential donor.

Kidney Donor:

The first steps in the workup process generally are tissue typing and crossmatch testing (for full explanation, see Who Can Be a Donor).

Assuming that you are a "Negative Crossmatch" -- meaning that you are a suitable donor for the potential recipient -- you next will likely see a transplant nephrologist, who probably will want to conduct another physical to ensure that you do not have any conditions that rule you out as a donor.

Laboratory and x-ray tests will be conducted to screen for kidney function, liver function, hepatitis and other viruses or infections. At least one and probably two 24-hour urine collections -- called creatnine clearance tests -- will be done to determine how well your kidneys are working. A chest X-ray and an electrocardiogram will be conducted to make sure your heart and lungs are normal. Potential female donors will probably undergo a gynecological exam and mammography.

After all labs and diagnostic tests have been completed, if the doctor agrees you are a good candidate to be a donor, you will be asked to take either a renal arteriogram or a computerized tomography (CT) angiography and intravenous pyelography (IVP).

If it is a renal arteriogram, which is designed to identify the blood vessels of your kidneys, a small tube will be inserted into the femoral artery in your leg and a dye will be injected. X-rays will then be taken to determine the mapping of your kidney's blood vessels.

Increasingly, however, doctors are using the less invasive spiral-type CT scan (or the even newer multislice CT scan) and IVP. In these tests, dye is injected into the bloodstream through a vein in your arm. The dye travels to the kidneys and the urinary tract. This scan then is able to identify your internal anatomy, helping determine if your urinary tract, kidneys and the blood vessels leading to them are normal.

These are all performed as outpatient procedures and you will go home following any of these tests. The information from these tests will help surgeons determine which of your kidneys would be best for donation. All other things being equal, the left kidney is the preferred choice.

If at this point you are approved to be the donor, the only further step will come about a week before the surgery, when the crossmatch tests will be repeated to insure that the crossmatch has not changed.

Liver Donor:

The first step in the workup process generally is crossmatch testing (for full explanation, see Who Can Be a Donor).

Assuming that you are a "Negative Crossmatch" -- meaning that you are a suitable donor for the potential recipient -- you next will likely see a transplant hepatologist, who probably will want to conduct another physical to ensure that you do not have any conditions that rule you out as a donor.

Laboratory and x-ray tests will be conducted to screen for kidney function, liver function, hepatitis and other viruses or infections. A chest X-ray and an electrocardiogram will be conducted to make sure your heart and lungs are normal. Potential female donors will probably undergo a gynecological exam and mammography.

After all labs and diagnostic tests have been completed, if the doctor agrees you are a good candidate to be a donor, you will be asked to undergo some screening tests to evaluate the suitability of the anatomy of the liver for donation. Possible tests used by different centers include:

• A hepatic angiogram. Designed to identify the blood vessels of your liver, a small tube will be inserted into an artery and a dye will be injected. X-rays will then be taken to determine the mapping of your liver's blood vessels.
• A computerized tomography (CT) angiography and intravenous pyelography (IVP). In these tests, dye is injected into the bloodstream through a vein. The dye travels to your liver. This scan then is able to identify your internal anatomy, helping determine if your liver and the blood vessels leading to it are normal.
• A cholangiogram. In this special liver X-ray, contrast dye is injected into the bile ducts either by inserting a needle directly into the liver or using an endoscope.
• A liver biopsy. This involves inserting a needle into the liver to remove a tissue sample.
• A magnetic resonance angiography (MRA) and TrueFISP (fast imaging with steady state precession.) Using a high magnetic field MR system, TrueFISP takes "slice" pictures of the abdomen in multiple planes depicting the internal structure of the liver and its relation to other organs. In addition, the volume of liver can be accurately measured to determine if it is of satisfactory size. When that test is finished, the patient receives contrast fluid intravenously and then MRA is performed, providing three-dimensional images of the blood vessels leading to and away from the liver.

All of these are performed as outpatient procedures and you will go home following any of these tests. The information from these tests will help surgeons determine which lobe of your liver would be best for donation.

Given the variations in the anatomy within the liver, only about 1 in 4 potential donors actually turns out to be a suitable liver donor.

If at this point you are approved to be the donor, the only further step will come about a week before the surgery, when the cross-match tests will be repeated to insure that the crossmatch has not changed.

As with all information provided in this site, it is offered for educational purposes only, and it is not intended nor implied to be a substitute for professional medical advice. Always consult your own physician or healthcare provider with any questions you may have regarding a medical condition.