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Assessment of Potential Donors
As a potential living liver donor, you'll got through an in-depth assessment of your health. It's your health that is of utmost importance to the transplant team. What they want to know is that:
With these three primary goals in mind, here is how donor candidates are medically evaluated.
1. Blood and Tissue Compatibility
Blood type. The first step is to determine your blood type. There are four blood types designated by the presence or absence of two antigens—the A antigen and the B antigen. Blood type A means you have the A antigen. Type B means you have the B antigen. Type AB means you have both antigens. Type O means you have neither antigen.
You must have a blood type compatible with the recipient or you will not be able to donate. Here is who can donate to whom:
The blood type is determined by drawing your blood and testing it.
Tissue type. Whether tissue typing is done appears to vary; some transplant centers mention it and others don't. Tissue compatibility looks at the match of human leukocyte antigens (HLA). Your antigens are determined by drawing blood and testing it. A similar test is run for the recipient, and the antigens are compared. The closer the match the better because the recipient is less likely to reject the donated organ. However, developments in anti-rejection drugs have made tissue matching less important. More details on this type of testing can be found in the section on kidneys.
Crossmatching. The third blood test is an important one. Crossmatching is a further testing of antigen compatibility. In this test, white blood cells from you are mixed with blood from the recipient. If the white blood cells are attacked and die, then the crossmatch is "positive," which is a negative as far as your ability to donate. It means the recipient is "sensitized" to the you—the recipient has antibodies to some of your antigens—so the recipient's immune system would turn on the donated organ. If the crossmatch is negative, you are compatible with the recipient.
2. Your General Health
At some point in the screening process, you will have a complete physical exam. When this occurs varies. You will share your medical history and possibly have a series of tests, such as a chest x-ray, electrocardiogram, blood tests, urine tests, and so on. Female donor candidates may also undergo a gynecological exam, pregnancy test, and mammogram. The purpose of the exam is to ensure you don't have any health conditions that would rule you out as a donor.
In the case of liver donation, there are specific health criteria for potential donors. The criteria depends on the transplant center, but here's a list of considerations:
3. Health of Your Liver
Following a general assessment of your health, the testing focuses on the integrity of your liver with these tests:
The information from these tests is used by the surgeon to determine the anatomy of your liver and to decide which lobe is best for donation.
Because these tests use x-rays, female donor candidates should inform the medical technician if you are pregnant or think you're pregnant. Also, the tests use a dye that some people may have an allergic reaction to. Let the technician know if you have had allergic reactions in the past, especially to iodine.
4. Other Assessments
Depending on hospital guidelines and transplant team protocol, there may be other assessments, such as psychological and financial reviews:
© 2012 International Association of Living Organ Donors, Inc.