Pre-kidney transplant evaluation from a living donor
What is it?
Living kidney donation is regulated in our country by legislation (Law no. 458 of June 26, 1967) and specific protocols (State-Regions Conference of January 31, 2002, State-Regions Conference of August 4, 2021) and is allowed between blood relatives, conditionally related (e.g. husband and wife) and also by unknown person (Samaritan donation). The act of donation must be a free, voluntary, and conscious act. In the living kidney donation program, the tests provided are such as to allow the verification of the willingness to proceed by the donor, his clinical suitability and the absence of diseases transmissible to the recipient. The ultimate goal of the entire evaluation process is to ensure the safety and psycho-physical well-being of the living donor.
The care path of the candidate to kidney donation for transplantation purposes is divided into 6 consequential phases that are closely related and interdependent with each other, which are:
- clinical nephrological-internal suitability
- immunological suitability
- surgical-anesthesiological suitability
- psychological and personal emotional adequacy
- opinion of the third party commission that expresses a judgment independent of the Transplant Center on the possibility of proceeding with the donation
- juridical/legal suitability
When is this exam indicated?
The evaluation of suitability for donation can be taken into consideration simultaneously with the evaluation of suitability for transplantation of the recipient.
How is it performed?
- Hematochemical tests, immunological examination (HLA typing)
- Instrumental examinations: ECG-Ecocardiogram-24 hours blood pressure monitoring
- Chest x-ray
- Ultrasound of upper and lower abdomen
- Sequential renal scintigraphy
- Mammography (women only)
- For women: gynecological examination, Pap test
- Psychiatric examination both donor and recipient
- Evaluation of the third party Commission and Magistrate
The tests performed may reveal clinical, psychological or legal contraindications to donation, depending on the characteristics of the donor/recipient couple.
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