- Provide the donor candidate with individualized estimates of short- and long-term risks
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- Evaluate risks with respect to predetermined transplant program acceptance thresholds
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- Obtain consent from the donor candidate for evaluation and donation
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- Determine ABO blood type and human leukocyte antigen compatibility
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- Inform incompatible donors about exchange programs and incompatible living donor transplantation options
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- Conduct a preoperative assessment as per local guidelines to minimize risk
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- 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, estimated GFR from the combination of serum creatinine and cystatin C, or repeat estimated GFR using serum creatinine
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- Assess albuminuria using albumin-to-creatinine ratio in an untimed urine specimen, and confirm albuminuria with AER in a timed urine specimen or by repeating albumin-to-creatinine ratio if AER cannot be obtained
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- Perform testing to identify cause of microscopic hematuria that is not reversible
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- Assess history and renal imaging for nephrolithiasis
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- Measure blood pressure before donation on at least two occasions
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- Assess metabolic and lifestyle risk factors for CKD and/or CVD before donation by obtaining:
- BMI measurement
- History of diabetes mellitus, gestational diabetes, and family history of diabetes
- Fasting blood glucose and/or glycated hemoglobin (HbA1c)
- Fasting lipid profile including total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, and triglycerides
- Present and past use of tobacco products
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- Screen for the following infections before donation:
- Human immunodeficiency virus
- Hepatitis B virus
- Hepatitis C virus
- Cytomegalovirus
- Epstein-Barr virus
- Treponema pallidum (syphilis)
- Urinary tract infection
- Other potential infections based on geography and environmental exposures
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- Perform cancer screening as per local guidelines
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- Assess family history of kidney disease
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- Confirm a negative quantitative beta-hCG pregnancy test immediately before donation in women with childbearing potential
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- Perform face-to-face psychosocial evaluation, education, and planning session with one or more trained, experienced health professionals
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- Select optimal surgical approach by an experienced surgeon
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- Respect donor autonomy during all phases of evaluation and donation
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- Perform annual postdonation follow-up care including:
- Blood pressure measurement
- BMI 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 psychosocial health and well-being
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