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I thought it might help to just go over what has happened so far, and the evaluation stages left.

I had an initial consultation with the surgeon and a Transplant Specialist Nurse. Various questions regarding my health, past and present and my families health as far as any illnesses they may have had.  My weight and height were checked.

Blood pressure
This gets taken as high blood pressure can cause damage to the kidneys.  Blood pressure is taken more than once during the evaluation period. 

Urine sample
Urine sample is taken and checked for underlying problems such as glucose, protein, bacteria, etc.

I have had blood taken three times and  checked for a variety of things. Blood group, tissue type …. infections, all sorts of things are checked for to make sure you are quite healthy.

Blood tests
Blood samples will be taken which is checked for blood group, tissue type, can show if there is anaemia, various infections etc etc . Various checks on the blood are done to make sure you are quite healthy and the kidney and liver are functioning okay ….

X-rays
A chest x-ray was taken.

Electrocardiogram (ECG)
I had an ECG (Electrocardiogram) where you have electrodes placed on you and your heart is monitored and the electrical impulses of the heart are recorded onto a graph and from that they can tell if there are any weaknesses in the heart.

Renal ultrasound
This is a non-invasive scan.  It  checks that there are two kidneys. Some people are born with only one kidney but are totally unaware of the fact.  The ultrasound can show the size of the kidneys, if there is any scarring or obstructions.   I had a small scar on the top of the right kidney which was probably due to an infection as a child.  It did not affect my ability to donate.  For those who have never had an ultrasound (most pregnant mums have) – then for a kidney ultrasound they wanted it done on a full bladder (that was the hardest part ..lol…). A gel is put onto your abdomen/side and then the technician moves a probe over your abdomen and sides and the probe can “see” your kidneys.  Once she had done the part that required the full bladder I was allowed to go and pee ! Then came back for the rest of the ultrasound. It is totally painless, not at all uncomfortable. The gel was a bit cold but that was all.  None of the tests I have had have been at all uncomfortable.  

A doctor was assigned to me to make sure that everything was being done that should to ensure I was healthy and fit enough to donate.  He checked my weight and height.  Asked me a few questions.   Listened to my heart which sounded okay. Blood pressure was 138/81. Peripheral pulses were present.  His opinion was that I was fit to proceed for further evaluation.  Ideally though I should lose some weight (being 89kb with a height of 1.6m). I also take HRT and was recomended I come off that for the donation. 

(Note: I do not take any form of  HRT which is derived from pregnant mares – such as Premarin etc.  I take kliovance which is plant based.  Speak to your doctor about switching if you are concerned about how the medication is produced).

I am working on the weight loss …. !

I saw the psychologist (see previous blog entry) and that is all fine.

Still to come ….
Psychiatrist Assessment
I am waiting to hear my appointment date for this.  They need to make sure I am fully aware of what I am committing myself to; that I am mentally okay and freely consenting to this procedure.

DMSA
This I have yet to have. It This is where they have to check the anatomy of each kidney. Arteries and veins have to be identified. It is not unusual for a kidney to have more than one artery.  These results go towards making a decision as to which kidney will be removed.   

GFR Test (Isotope Glomerular Filtration Rate).
I also have this to come. I believe I will be having this same day as the DMSA. The GFR is a test to assess the capability of the kidney to ’clear’ the blood of a substance. A small amount of dye is injected into a vein and blood samples are taken at hourly intervals for three/four hours, to measure the renal clearance of the dye. 

Finally I have to see the Consultant Nephrologist again  as he gives the final decision as to whether I am medically fit enough etc to donate a kidney.

All the information is given to an independant Assessor and I have a meeting with him. He  needs to make sure I understand everything etc etc. He then makes a report and presents to the Human Tissue Board and seeks their permission for the donation to go ahead.  The producing of the report and seeking permission can take up to a month in total.

It was explained to me that there was no guarantee that it would be keyhole surgery.  The surgeon would make that decision once both kidneys had been evaluted etc. It is not unusual for a kidney to have more than one artery and vein and if it turns out that there are two or three arteries and/or veins etc, it maybe that the operation would easier  with open surgery.  So that does affect recovery time.  Keyhole surgery – the stay in hospital is shorter by a couple days I believe and the recovery time  is much quicker.

I have some personal committments late Autumn  that are a must to keep and may involve physical activity. So allowing enough time for the donation and full recovery, it may be difficult to make the actual donation any earlier than late November/December.  That is fine and allows plenty of time for the rest of the tests and assessments to take place. Approval for the donation will be sought once my committments are over.  I certainly don’t want to be under any pressure during my recovery especially as I don’t know if keyhole or not – so need to be sure  there is plenty of time afterward to get back to normal.

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9 Responses to “Kidney Donor Evaluation Tests ….”

  • Ian Thompson:

    Thank you so much for this.
    I am considering donating to either a friend if we are a match or if not to anyone that needs it.

    This has been a great help in easing my mind doubt what it entails.
    the leaflets etc are all a bit regimented.

    Thanks again and I hope it went well

  • Diane:

    Hi Ian,
    Thanks for commenting. Well done on wanting to donate. I do hope your friend and you are a match, but if not very generous to then donate to anyone.

    I know what you mean about leaflets 🙂 ….. If you want any information please do either just post here or contact me directly via the Contact link top right of page.

    Wishing you all the best
    Di

  • Emelia:

    Hello, first I must say your website is so informative. I am an altruistic kidney donor a few years ago now, and appear now to be suffering from high blood pressure. I have no symptoms though today it was 159/109. Should I visit my gp or wait until I go for annual check up. I have one of those bp reading machines at home to monitor it. My family history is high blood pressure, type 2 diabetic, high cholesterol, under active thyroid.
    You or anyone who reads this could possibly shed some insight??
    Before donating my bp was perfect.

    Thanks, Emilia

  • Diane:

    Hi Emelia,
    Thanks for posting. The high blood pressure may have nothing at all to do with the kidney donation. But regardless of that, do not wait until your annual check up. Please go see your GP who can give you something to bring the BP down. If you wait until your annual check up, they will only refer you back to your GP anyway 🙂

    So please go make an appointment, especially as high BP runs in the family. You need to get it seen to as soon as you can.
    Di

  • Emelia:

    Di,

    Thanks for your reply. I shall try and book appt in the morning. I have heard several conflicting stories about systolic and diastolic blood pressure, one being the the diastolic reading being high is associated with kidney function.
    Time to visit gp it is
    Thanks
    Emelia

  • Diane:

    Well, it could be that a GP etc has said to someone, this reading is high, which is what you get re kidney. BUT …. let’s put it this way … my partner had a major stroke over Christmas …. during his hospital stay and for a month after he had high blood pressure – both readings were high i.e. 183/115. Yet … his kidney function was fine :). 3.5 months after the stroke his kidney function is still fine, BP is high but coming down. About 2 weeks before his stroke he actually had a general GP check up and his BP was fine there. So conclusion leads us to believe the stroke was the cause of the high BP …. mind you my partner is 73 years old.

    What I am getting at is there re many reasons for high BP readings.

    When I went for my annual check up for kidney donation last June I had high BP (first time I have had high BP) this is 5 years after donating. I still have high BP as the medication they gave me had side effects I could not live with. We are still trying to sort. But also at my annual donation check up all my kidney functions were very good.

    Back to connection between kidney and high BP. Yes donors are told before they donate that they are more susceptible (sp?) to high blood pressure, but as you can see from what I have written above many other things can give high blood pressure.

    Ask your GP to check your kidney function as well …. as you are concerned about why you have got high BP. I am not saying it is not kidney related, just that many other reasons can cause the high readings.

    My high BP I am sure is due to being very overweight, too much salt and caffeine in my diet and not enough exercise!!! For various health reasons the overweight and exercise are hard to deal with. The other two I can 🙂

    Please let me know how you get on.
    Di

  • Emelia:

    Sorry to hear about your partner. You say at your last check up you had high bp, what was it and did they do bloods for you. Did the gp or the hospital prescribe you medication? When are you due next for your annual check up?
    Emelia

  • Diane:

    Hi Emelia,
    I don’t actually know what my BP was at my last annual check up (June last year). They just said it was a bit high and it may be temporary or not and suggested I went to GP to get it checked out.

    When I went to GP my BP was 162/110. She suggested I went to this center to have a 24 hour BP monitor fitted. This actually proved harder than I thought (getting to the center). I did have a home BP so after a week I made another appointment with the Dr. and said to just go ahead and treat me for high BP – we didnt need the 24 hour monitor testing. She took my BP again, and was still high so put me on Amlodipine.

    About 2 weeks after starting on the medication (I was on holiday by now in Madeira) – I started to have some of the side effects that I read about. both my feet became swollen, including the soles of my feet. Starting from a few inches above the ankles and right down into my feet. Of course this was very painful walking. Also I became ridiculously tired, wanting to just sleep all the time.

    Not having access to a GP as on holiday, I did stop the medication after about day 5 of the side effects which were not improving. Very soon I went back to normal. On my return from holiday I did some research and started to take Hawthorn Berry http://umm.edu/health/medical/altmed/herb/hawthorn
    Although scientific studies have been done on some heart conditions that respond favourably to Hawthorn Berry. No study has been done re blood pressure and there are only word of mouth positive report.

    Anyway …. I booked appointment with my GP – now it is hard to get an appointment within 2.5/3 weeks!! So I had just under 3 weeks on hawthorn berry tincture …. when the GP took my blood pressure it was down to normal!! yeah!! I told her what had happened re her medication and the Hawthorn and she was happy for me to continue on it and to monitor myself at home with BP monitor.

    But …. my BP has gone up again, it is now 166/115 … so another appointment on the card for GP.

    Could be my fault. I was told to reduce salt, caffeine and exercise more. I started off well, then actually just forgot, and went back into bad habits of too much of two of them and not enough of the third! So …?? who knows if that is why BP went up again.

    Have yet to see the doctor … I have also started to have some palpitations … maybe once a week … which I never had before.

    I am not sure it can ever be shown what connection there is [with me] re kidney and BP …. I could have got high BP anyway ??? Who knows.

    My next hospital check up is in June … I am hoping to have this BP cleared up by then. Yes they took bloods and urine to test and everything came back normal last time.

    Di
    x

  • Diane:

    I have just edited the above as my fingers typed “sugar” whereas my brain was saying “salt” 🙂

    Di

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