A transplant will not take place until the entire donor and recipient work ups are done with satisfactory results. The recipient has to be tested first and approved for transplant. They will be placed on the wait list whether they have a living donor or not.
1. Blood group matching
- Testing for the blood type of the donor and potential recipient is done next to establish compatibility.
- The transplant center does NOT perform incompatible blood group transplants at this time.
- If the donor and recipient are not matching, the transplant will not be done, but they will remain on the transplant wait list. The team will provide counselling for the next best steps for care.
2. HLA Tissue typing and crossmatch
- Once blood group compatibility is established, tissue typing and cross-matching will be done.
- Human Leukocyte Antigen (HLA) is a type of protein marker found on cells in the human body. These are unique to every person, except identical twins. The human body uses these cells to identify which ones belong to the body and which do not.
- The closer the match of HLA markers between donor and recipient, the better the outcomes of the transplant. But it is possible to have mismatches and still transplant under certain conditions.
- The crossmatch is a very important test that identifies if the recipient’s body will react to the donor’s tissue. In this test, the donor’s blood sample is mixed with sample from the recipient. If the recipient’s blood has antibodies to the donor’s sample, it means the crossmatch is positive.
- Antibodies are proteins produced in the blood in response to a foreign cells called “antigen”; antibodies destroy antigens.
- A positive crossmatch indicates that the recipient’s body will attack and destroy the donor’s kidney. In such a case, the transplant cannot take place, and the search for another donor must resume.
3. Pre-donation evaluation
- If the initial testing goes well, the donor will move forward with the process.
- The donor will be assessed more thoroughly by the nephrologist, and the transplant surgeons.
- This phase will include all of the following tests:
- Past medical history
- Complete physical
- Urine samples
- Infectious disease testing
- Chest x-ray
- Other testing might be ordered based on the donor’s health