Living Kidney Donor Evaluation: What to Expect

 

Getting Started: How to Get Tested for Kidney Donation

Once you’ve decided you want to be evaluated:

• If you’re donating to someone you know, you contact the transplant center where that person is listed.

• If you’re donating to someone you don’t know, you can contact any transplant center that does living donor transplants.

You’ll complete a health history form (usually online or on paper) with questions about your medical conditions, medications, mental health, and lifestyle. After they review it, the living donor team will reach out to schedule your evaluation.

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Before the Full Evaluation

Before bringing you in for 1–2 full days of testing, the center usually:

• Has you do blood and urine tests either at the center or a local lab.

• Checks for any obvious health issues that would clearly rule out donation before asking you to travel.

If you live far away, they may suggest staying overnight nearby. Many centers have discounted hotel options, and there are financial programs that may help with travel, meals, and lodging during the evaluation steps.

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Who You’ll Meet: The Living Donor Team

During your evaluation visit, you’ll meet a team whose job is to look out for your safety and well‑being:

• Nurse Coordinator
  Your main point of contact. They guide you through the process, help with scheduling, explain lab results, and keep you updated about where you are in the evaluation.

• Nephrologist (kidney doctor)
  Reviews how well your kidneys work and checks for any kidney or medical issues that could put you at risk if you donate.

• Social Worker
  Talks with you about time off work, who will help you after surgery, your emotional well‑being, and any financial concerns. They also help connect you with resources for travel, lodging, and meals if you qualify.

• Surgeon
  Reviews your past surgeries, explains how living donor surgery works (usually small incisions in the belly), and talks about pain control and recovery.

• Dietitian
  Reviews your eating habits and explains what a healthy, balanced diet looks like before and after donation.

• Independent Living Donor Advocate (ILDA)
  A separate team member whose only job is to protect you. They make sure no one is pressuring you, help you think through your reasons for donating, and are available at any point in the process—even after surgery.

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Medical Tests You’ll Have

While every center is slightly different, most evaluations include:

• Imaging tests
  Chest X‑ray, CT scan, and kidney imaging to see the size, shape, and blood flow to each kidney. This helps decide which kidney is safest to donate and confirms you’ll be left with the healthier one.

• Lab work
  More blood work and urine tests—even if you had some before—to double‑check that you’re still healthy enough to keep moving forward and to run any additional tests the team needs.

All medical costs directly related to the evaluation—lab work, imaging, and visits with the team—are paid for by the recipient’s insurance.

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What Costs Are Not Covered

The recipient’s insurance usually covers all medical care directly tied to donation (evaluation, surgery, hospital stay, follow‑ups). It does not typically cover:

• Routine care you should be getting anyway (like annual dental cleanings, mammograms, colonoscopies, or OB/GYN visits).

• Non-medical costs like lost wages, gas, parking, hotels, meals, childcare, or pet care.

Many centers and outside programs can help with some of these costs. The social worker can help you explore support options and low‑cost clinics if you don’t have your own health insurance.

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How Long the Evaluation Takes

The total time from first contact to being approved can range from a few months to up to a year. It depends on:

• How quickly you can schedule and complete testing and appointments.

• How busy the transplant center is and how often they do donor evaluations.

• Whether you need extra tests to investigate anything in your medical history or lab results.

Ask your living donor team what timelines are typical at their center and what you can do to keep things moving smoothly.

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If You’re Approved to Donate

If the team agrees you’re healthy enough to donate:

• They will call you first to share the news and confirm that you still want to move forward.

• Only after your “yes” will they let the recipient know there is an approved donor.

• You and the recipient (if there is one) will then work with the team to schedule surgery for a date that works for everyone.

You still have the right to change your mind at any time.

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If You’re Not Approved to Donate

If you’re not approved, the most common reason is that donating could put your health at risk—either now or later in life. The team’s job is to protect you first.

You can:

• Ask why they made their decision and whether any issues can be worked on and rechecked later.

• Consider seeking evaluation at another transplant center, understanding there’s no guarantee another center will approve you.

• Have some test results shared with another center to avoid repeating everything.

If you were hoping to donate to someone specific, remember: other options like another living donor, paired exchange, or deceased donor transplant may still be available for them.

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Questions You Can Ask the Team

Good questions for your living donor team include:

• “How long does the evaluation usually take at your center?”

• “What can I do to help the process go as smoothly and quickly as possible?”

• “Does your center offer paired exchange if I’m not a match with the person I want to help?”

• “What help is available for travel, lodging, and lost wages while I’m being evaluated and recovering?”

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