An extensive evaluation must be completed before you can be placed on the transplant list. Testing includes:
- Blood tests
- Diagnostic tests
- Psychological and social evaluation
Blood tests are done to gather information that will help determine how urgent it is that you are placed on the transplant list, as well as ensure that you receive a donor organ that is a good match. Some of the tests you may already be familiar with, since they evaluate the health of your kidney and other organs. These tests may include:
- Blood chemistries - these may include serum creatinine, electrolytes (such as sodium and potassium), cholesterol, and liver function tests.
- Clotting studies, such as prothrombin time (PT) and partial thromboplastin time (PTT) - tests that measure the time it takes for blood to clot.
Other blood tests will help improve the chances that the donor organ will not be rejected. They may include:
- Your blood type
Each person has a specific blood type: type A+, A-, B+, B-, AB+. AB-, O+, or O-. When receiving a transfusion, the blood received must be a compatible type with your own, or an allergic reaction will occur. The same allergic reaction will occur if the blood contained within a donor organ enters your body during a transplant. Allergic reactions can be avoided by matching the blood types of you and the donor.
- Human leukocyte antigens (HLA ) and panel reactive antibody (PRA)
These tests help determine the likelihood of success of an organ transplant by checking for antibodies in your blood. Antibodies are made by the body's immune system in reaction to a foreign substance, such as a blood transfusion or a virus. Antibodies in the bloodstream will try to attack transplanted organs. Therefore, persons who receive a transplant will take medications that decrease this immune response. The higher your PRA, the more likely that an organ will be rejected.
- Viral studies
These tests determine if you have viruses that may increase the likelihood of rejecting the donor organ, such as cytomegalovirus (CMV).
Diagnostic tests that are performed are necessary to understand your complete medical status.
The following are some of the other tests that may be performed, although many of the tests are decided on an individual basis:
- Renal ultrasound - a non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.
- Kidney biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from the kidney for examination under a microscope; to determine if cancer or other abnormal cells are present.
- Intravenous pyelogram (IVP) - a series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
The transplant team will consider all information from interviews, your medical history, physical examination, and diagnostic tests in determining whether you can be a candidate for kidney transplantation. After the evaluation and you have been accepted to have a kidney transplant, you will be placed on the United Network for Organ Sharing (UNOS) list.