Table 1.

Checklist for the evaluation, care, and follow-up of living kidney donors

ChapterTopicChecklist Item
1Evaluation goals, decision-making framework, roles and responsibilities✓ Provide the donor candidate individualized estimates of short- and long-term risks
✓ Evaluate medical risks with respect to predetermined transplant program acceptance threshold
2Informed consent✓ Obtain consent from the donor candidate for evaluation and donation
3Compatibility testing, incompatible transplantation, paired donation✓ Determine ABO blood type and human leukocyte antigen compatibility
✓ Inform incompatible donors about exchange programs and incompatible living donor transplantation options
4Preoperative evaluation and management✓ Conduct a preoperative assessment as per local guidelines to minimize risk
5Predonation kidney function✓ Estimate GFR using serum creatinine–based estimating equations and confirm with one or more of the following according to availability: measured GFR using an exogenous filtration marker, measured creatinine clearance, eGFR from the combination of serum creatinine and cystatin C, or repeat eGFR with serum creatinine
6Predonation albuminuria✓ Assess albuminuria using albumin-to-creatinine ratio in an untimed urine specimen and confirm albuminuria with albumin excretion rate in a timed urine specimen or by repeating albumin-to-creatinine ratio if albumin excretion rate cannot be obtained
7Predonation hematuria✓ Perform testing to identify cause of microscopic hematuria that is not reversible
8Kidney stones✓ Assess history and kidney imaging for nephrolithiasis
9Hyperuricemia, gout, and mineral and bone disease✓ Assess history of gout
10Predonation BP✓ Measure BP prior to donation on at least two occasions
11Predonation metabolic and lifestyle factors✓ Assess metabolic and lifestyle risk for CKD and/or cardiovascular disease by obtaining the following prior to donation:
 • Body mass index measurement
 • History of diabetes mellitus and gestational diabetes and family history of diabetes
 • Fasting blood glucose and/or glycated hemoglobin (hemoglobin A1c)
 • Fasting lipid profile, including total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides
 • Present and past use of tobacco products
12Preventing infection transmission✓ Screen for the following infections before donation:
 • HIV
 • Hepatitis B virus
 • Hepatitis C virus
 • Cytomegalovirus
 • Epstein–Barr virus
 • Treponema pallidum (syphilis)
 • Urinary tract infection
 • Other potential infections on the basis of geography and environmental exposures
13Cancer screening✓ Perform cancer screening as per local guidelines
14Evaluation of genetic kidney disease✓ Assess family history of kidney disease
15Pregnancy✓ Confirm a negative quantitative human chorionic gonadotropin pregnancy test immediately before donation in women of childbearing potential
16Psychosocial evaluation✓ Perform face-to-face psychosocial evaluation, education, and planning session with one or more trained, experienced health professionals
17Acceptable surgical approaches for donor nephrectomy✓ Select optimal surgical technique by an experienced surgeon
18Ethical, legal, and policy considerations✓ Respect donor autonomy during all phases of evaluation and donation
19Postdonation follow-up care✓ Perform annual postdonation follow-up care that includes the following:
 • BP measurement
 • Body mass index measurement
 • Serum creatinine measurement with GFR estimation
 • Albuminuria measurement
 • Review and promotion of healthy lifestyle practices, including exercise, diet, and abstinence from tobacco
 • Review and support of psychologic health and well-being
  • Reprinted from ref. 31, with permission.