An application, a jug of pee, and three appointments – The living kidney donation process: PART 1
By Jon Lee, Founder of Us For Them
As we begin this mission, I want to be perfectly transparent. I have almost NO idea what I’m doing. That said, I’m hearing a lot of from the early adopters of this idea. Most people have questions about the actual process of donating a kidney. Like, what exactly does it entail? I’ll probably devote a few posts to this topic this year, but let me start with everything I remember taking place before the actual donation.
The evaluation process was comprehensive, but very simple, and comprised only three appointments. That’s right. The entire pre-donation process for me involved filling out and application and going to exactly three appointments before surgery. Three!
Step 1: An online application
Before the first visit I filled out an application online. If you’re interested in being evaluated and you live in North Texas, I highly recommend Medical City Dallas. You can fill out the application here to see if you qualify. I’m a boringly healthy guy. I mean I’m not like super health eater and I’ve never been accused of having ANY athletic ability, but I’m in decent shape and I don’t have any chronic health issues. I am very rarely sick. I didn’t get the flu until I was 35 years old. If you’re a fairly healthy adult you’ll probably pass the application process easily. I think I finished it in less than 10 minutes.
Step 2: A big jug of pee
From there they send you a big jug to pee in for 24 hours. Choose a day and start collecting your pee until the next morning. Pro tip: Do it on a weekend. The whole “collecting your urine at work” logistics are… tricky.
Step 3: Simple labs and vitals
The next day you’ll turn in your urine jug, get some simple blood work done for labs, and get your vitals checked out (weight, heart rate, blood pressure… simple stuff). The whole appointment took me less than half an hour.
Me on evaluation day… putting on my brave face… or something.
Step 4: Evaluation Day
If all looks good from the first set up labs, they’ll call you in for a pretty full day of evaluations. You’ll get a physical, more blood work, another urine sample, chest X-ray, EKG, CT scan, a psychological/ social welfare evaluation (to make sure you can afford to take off work, have people who can help with recovery and that you aren’t crazy). It’s all very simple and pretty painless, but they require you to fast for most of the day. Oh, and they make you watch some cartoons.
Step 5: The waiting game
From there your case (all of your test results and information) are submitted to a committee made up of transplant surgeons and medical professionals in the organization. They’ll evaluate everything comprehensively, and if all checks out, approve you as a donor. After that you, you wait for a match, unless of course you already have a donor that you match for. In that case you just schedule a date for surgery. Otherwise, if you’re like me (a kidney exchange donor in search of a matched pairing) or if you’re a non-directed donor, they’ll probably give you a very broad estimate to set expectations of finding a match. They told me it could be a couple of months up to a couple of years potentially. I’m not sure if they tell most donors that, but I suspect they do.
Step 6: The phone call
The transplant coordinator at your center tells you they found a match and asks about your schedule. You are in control of the schedule. They can work around your life. For me it worked out perfectly. I was able to schedule the donation to take place during a very rare lull in my travel schedule for work.
Note: This was the moment that the whole thing became real to me. I was sitting in a client meeting in Philadelphia when I received the call. They’d found a match! They were asking about scheduling something in the next three weeks! The phone call caused a certain level of existential whiplash for me. I’d grown comfortable with waiting game after a few weeks - knowing that I was pretty much committed to this journey (although a donor can back out at any time for any reason), but not really thinking about it all that often. Suddenly I was scheduling things. I was informing my co-workers. I was letting my extended family in on the news. It was fast. It was emotionally confusing. But it was the thing I’d been waiting for.
Be prepared for the phone call to mess with you a bit. It’s natural.
Step 7: The preproduction meeting
Sorry. I couldn’t resist one bad advertising joke.
My last pre-surgery appointment occurred about a week prior to the surgery. It involved another set of simple labs and some logistical instructions for the day of the surgery. More blood and urine samples (get used to peeing in cups a lot) and a few meetings to review your post-surgery plan (who is going to help you get home and get around for the first couple of days, how prescriptions will work, where to go the day of the surgery and what time to get there, etc.).
That’s it. An application and three appointments. And you’re ready to save and extend somebody’s life.
If you’re a donor, I’d love to hear from you. Was your experience different than mine? Did I forget any important details that would be helpful for people considering living kidney donation? Let me know.