Will a Center Evaluate More Than One Potential Donor at a Time?
If you need a kidney transplant and several people have agreed to be tested as potential donors, you might be wondering how the transplant center will test them. Will the center evaluate several potential donors simultaneously, or will it screen one candidate at a time and only move to the next if the first is deemed ineligible?
Why Testing Potential Kidney Donors Individually vs. Simultaneously Matters
This is an important question, because the living donor testing process can sometimes take weeks, or even months.
Potential donors must undergo a thorough medical evaluation, meet with specialists, and potentially complete routine screenings such as a mammogram or colonoscopy.
If one potential donor goes through the entire process and is deemed ineligible to donate, the patient is back to square one, and the center must start again with a new potential donor. This can significantly prolong the wait time for someone in kidney failure, meaning additional weeks of dialysis and declining health.
On the donor side, if someone registers as a potential donor but has to wait while another potential donor is evaluated, they may lose interest or change their minds. They might even assume they are not needed because other donors have already stepped forward.
Will My Center Test Multiple Potential Donors at Once?
The question of whether potential donors are tested individually or simultaneously comes down to the transplant center. Each center has its own rules, so it’s important to understand your center’s specific policies.
Many transplant programs now recognize the advantages of evaluating multiple donors at once. This can:
1. Speed Up the Transplant Process
If only one donor is evaluated at a time and that donor is ruled out late in the process, the timeline resets. Evaluating multiple donors early on helps avoid delays and get the recipient to transplant faster.
2. Increase the Chance of Finding a Good Match
Even if someone seems healthy, problems can emerge late in the evaluation, such as compatibility issues, blood pressure concerns, unexpected lab results, hidden illnesses, or anatomical issues found on imaging. Having more than one candidate in the pipeline increases the chance of finding the best match.
3. Help More People Get Transplanted
If multiple potential donors for a single patient are approved to donate, one can donate to the original recipient and the rest can help someone else get a transplant by donating through the Voucher Program.
Even though parallel evaluations are becoming more common, some transplant centers still prefer to evaluate donors one at a time due to:
- Staffing and Resource Constraints: Donor evaluations requires staff and facility space, and smaller programs may not have the capacity to process multiple donors simultaneously.
- Cost Issues: Each evaluation involves significant medical testing, which can be costly for centers. Some centers want to confirm eligibility for one candidate before moving to the next to avoid unnecessary costs.
- Consideration for Other Patients: To keep the process moving for everyone, some centers limit how many donor evaluations they conduct at once. Otherwise, a single patient with many potential donors could occupy all the evaluation slots and slow down the process for others.
How the National Kidney Registry Can Help
Potential donors who register with the National Kidney Registry (NKR) could have a better chance of being evaluated more quickly and not having to wait for other candidates to be tested.
The “center best practices” that all NKR Member Centers must follow includes working up multiple donors for a single patient to reduce wait times and get the patient transplanted as soon as possible.
What You Can Do if Multiple People Want to Donate
If more than one person is willing to donate on your behalf, here’s what you can do to increase the chances of them being tested in parallel.
1. Ask the Center About Their Policy
As someone who needs a kidney transplant, it is in your best interest to have as many potential donors tested as possible. A simple question—“Do you evaluate multiple donor candidates at once?”—can clarify the process and help set expectations.
2. Encourage All Potential Donors to Register
Even if your center will only evaluate one donor at a time, it’s important to encourage all potential donors to register with the NKR directly or through your microsite and start the testing process. The sooner they are in the system, the better chance they have of being evaluated quickly.
3. Ask Potential Donors to Consider the Voucher Program
If a potential donor only wants to donate to you, the options are more limited. However, if they tell the transplant center they want to donate to you but are also open to donating to someone else if they are not a match, the center may be more inclined to evaluate them alongside other donors because their donation could facilitate an additional transplant.
