What are some of the core basics you need to be to be a living donor, well alive is one, sorry had to make a joke. Now some of these things can vary based on the hospital that will be performing your surgery. As a donor you need to go through an extensive medical background check. IU health requirements are directly copied from IU health living donor education packet;
“Living donors must be chosen carefully to avoid outcomes that are medically and psychologically undesirable. You will be evaluated with consultations, lab tests and various procedures to determine the medical appropriateness of liver donation. IU Health takes all reasonable precautions to provide confidentiality for both the donor and the recipient.
You will interact with many members of the transplant team who may include:
• A Financial Coordinator is a nurse case manager who will work with your recipient’s insurance so the donation process will be at no cost to you, the donor.
• The Transplant Coordinator is a registered nurse who specializes in the transplant and donation process. Your coordinator will provide you with education regarding the donation and transplant process. You are encouraged to ask questions and to become fully informed about the liver donation and transplant process.
• A Living Donor Advocate (LDA) is independent of the recipient transplant team and acts solely on your behalf to ensure that your rights are protected and that your decision to donate is informed and voluntary. The LDA is available to you throughout the donation process. Before any evaluation testing is started, you must have an initial interview with the LDA.
• A Hepatologist is a physician who specializes in liver disease. The hepatologist will assess the function of your liver and the safety of your donation. You and your recipient will have different hepatologists.
• A Surgeon will meet with you and discuss living liver donation, the risks of the surgery and the possible complications after your donation.
• An Anesthesiologist will meet with you prior to donation to review your medical history and discuss your risk(s) from anesthesia.
• A Psychiatrist or Psychologist will conduct an in-depth evaluation and assessment of your psychosocial history, the relationship between you and the intended recipient and your ability to cope with the donation process.
• A Social Worker is available to provide support and identify resources that may be beneficial when needed.
• A Registered Dietitian is available to perform a nutritional assessment and provide nutrition education and support.
• Some potential donors may be referred to other service(s) for consultation. For example, some patients need to be seen by a pulmonologist (lung doctor) or a cardiologist (heart doctor) to assess for other medical conditions.
Multiple tests are done to determine if you are a suitable donor. The following tests may be included in your evaluation process. Remember, other tests may need to be done based on the results of these tests.
• Blood tests are done to determine your blood type and identify reasons that you might not be able to donate part of your liver. These tests will screen for your immunity to or the presence of specific viruses, including human immunodeficiency virus (HIV). Additional blood tests may be used to determine how well other organs are functioning.
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• A chest X-ray helps identify any problems with your lungs.
• A urine test is used to screen for the presence of urinary tract infections and kidney disease.
• An EKG, echocardiogram and/or stress test will show how well your heart is functioning. This will help your physician decide if your heart is strong enough for surgery.
• A CT scan will be done to identify anatomy, blood flow to and from your liver and the presence of tumors.
• An MRCP/MRI will help determine anatomy of the bile ducts.
• A liver biopsy may be performed if BMI is 30 or higher, or if an abnormality is suggested by imaging. This is a test in which a needle is used to remove a small portion of your liver. The tissue is then looked at under a microscope to identify any abnormalities and fat content. There are risks involved with a liver biopsy that will be discussed with you prior to the procedure.
• Pulmonary function tests may be required, especially if you have a history of smoking or a history of lung disease. This is a breathing test to analyze your lung capacity and function.” (IU Health Living Liver Donation Patient Education, 2021).
It is a lot to ask of someone and is to be thought out carefully before making such a big life changing decision. This has been something I have thought a lot about and I try to be very transparent with people about what my worst days look like and that they can potentially get a glimpse into my life and I don’t wish it upon anyone. People may say it’s no big deal but until you truly have been there you can’t understand the pains and the death feeling that can come along with it. You think the flu is bad, well honey you ain’t seen nothing yet!
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