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What Disqualifies You from Being a Kidney Donor?

Kari Rancourt, Living Donor Transplant Coordinator, Hartford Hospital

If you are interested in donating a kidney, the first step is finding out if you are qualified to donate. The easiest way to see if you are qualified to donate a kidney is to visit the National Kidney Registry’s online donor registration and enter your name, phone number and email.

You will receive an email with a link to a medical screening questionnaire to start the process. Completing the medical screening questionnaire is the first step toward determining if you are eligible to donate a kidney.

To anyone thinking of donating a kidney, I would say to trust the process. The transplant team will not let you have the surgery if you won’t be OK. Be honest about your health conditions and know that they will make the best judgment for you.

Jonathan Calixto, living kidney donor

Requirements for kidney donation vary by transplant center, but in general, you must be in good health, with normal kidney function and no major physical or mental illnesses in order to become a living kidney donor.

Following are some reasons you may be disqualified from donating. These are for informational purposes only. If you want to be a living kidney donor, do not disqualify yourself based on any of the following factors—let the transplant center determine if you are qualified.

Age

Age is sometimes given as a reason for disqualifying a potential kidney donor. The minimum age to become a kidney donor is 18–25 depending on the transplant center. There is no official maximum age limit for becoming a living kidney donor, though it does tend to be more difficult for older potential donors to qualify. However, age alone should not be a disqualifier.

Be persistent about becoming a donor, no matter how old you are. I was told by my center that four out of five centers would have refused to consider me as a donor due to my age. But just age does not speak to an individual’s health.

Sander Orent, donated a kidney at age 72

According to the latest data from the Organ Procurement and Transplantation Network (OPTN), which tracks every organ donation and transplant in the U.S., 2.4% of all living kidney donors to date have been over 65, while 23% have been between the ages of 50 and 64.

The percentage of older donors has been steadily increasing as medical technology has made the surgery safer and transplant centers have become more willing to accept older donors who are otherwise healthy: so far in 2023, 6.4% of living kidney donors nationwide have been over 65, and 31.7% have been 50–64. The National Kidney Registry has facilitated kidney donations from donors in their late 70s, and in 2019, Frank Dewhurst donated a kidney at age 84.

If you want to donate to someone you know will need a kidney transplant at some point in the future but are concerned you may be too old by the time your intended recipient is ready for transplant, the NKR’s Voucher Program lets you donate now and give vouchers to up to five family members. If any of the voucher holders need a kidney in the future, they can activate their voucher to receive priority consideration for a well-matched kidney from a living donor through the NKR. Only one voucher can be redeemed per voucher donor.

Weight/BMI

Weight, or body mass index (BMI), is another potential disqualifier for becoming a kidney donor.

A BMI of 30–35 falls into the category of Class 1 obesity, while a BMI of 35–40 qualifies as Class 2 obesity. Having obesity makes surgery more risky, and a donor with obesity is at increased risk for developing diabetes and other complications. To find your BMI, use this calculator from the CDC.

I knew that being overweight would exclude me from donation, and worse, put me at risk of needing medical intervention in the long run as opposed to helping others. I carefully and methodically lost a pound a week and resumed exercise, which was always a passion of mine. I was in peak health for my surgery.

Iris Bartov, living kidney donor

Potential kidney donors with a BMI over 35 are usually rejected as kidney donors. Those with a BMI of 30–35 may be encouraged to lose weight before surgery. Some transplant centers even offer special programs to help potential donors lose weight to help them qualify.

If you are interested in becoming a kidney donor but are concerned that you will not be accepted because of your weight, the best way to find out if you are eligible, what you may need to do to become eligible, and which centers will accept you as a donor candidate, is to complete the NKR’s online donor screening.

Disease or Medical Condition

Kidney donors must be healthy, so potential donors may be disqualified if they have a serious medical condition, such as uncontrolled high blood pressure, diabetes, active or recently treated cancer, hepatitis, or acute or recurring infections.

Again, if you are interested in becoming a donor and have one of these conditions, don’t assume you will be rejected—let the transplant center make the decision.

Guidelines and criteria change all the time. For example, having HIV used to automatically disqualify someone from becoming a donor, but in recent years, it has been determined that it is safe for people with HIV to donate a kidney to recipients who are also HIV-positive. In 2019, Johns Hopkins performed the first living donor HIV-to-HIV kidney transplant in the United States.

Mental Health Issues

You may also be disqualified from becoming a kidney donor if you have a serious mental health condition, are misusing drugs or alcohol, have dementia, or are mentally compromised in a way that would make it difficult for you to safely undergo testing, surgery and recovery. The best way to determine whether you are qualified is to register as a donor and complete the medical evaluation.

Most mental health conditions do not automatically disqualify a donor. It is important to discuss any mental health history with your transplant center team so you can receive individualized recommendations for support throughout the process.

Coercion

Donation must always be voluntary. If you are feeling pressured by someone to donate, please discuss your situation with your transplant center. It is illegal to accept compensation for donation. Reimbursement for out of pocket expenses is perfectly acceptable. Your transplant center may have resources to help, and Donor Shield is available to help with lost wage or travel concerns.

Don’t Disqualify Yourself as a Donor

It’s important for potential donors to know that many conditions can be improved or managed in a way that enables them to become a donor, so don’t count yourself out. If you are truly interested in becoming a kidney donor, go ahead with the medical screening and leave the decision to medical professionals whose job is to make sure every living kidney donor is able to donate safely.

Options for Disqualified Donors

It can be disappointing to be disqualified as a donor. Many conditions can be managed or improved, which might allow a previously disqualified donor to eventually be approved. Ask your transplant center for guidance on ways you might be able to qualify in the future. You may also consider seeking a second opinion at another transplant center. If you have been disqualified for reasons that cannot be reversed, you can still help. Raising awareness about living donation, as well as the transplant community’s commitment to donor safety, is extremely important.