PSA should be checked in males per American Urological Association screening guidelines (). Laboratory abnormalities – i. Proteinuria <180 mg on 24 hr urine is acceptable 181-250 mg Order an albumin to Cr ratio on a spot urine. Patient may be a donor – if value is < 0.03 >250 mg not acceptable for donation – ii. Persistent microscopic hematuria(UA x 2 with microscopy demonstrating > 5 RBC/ hpf). Proceed with the following evaluation: Cystoscopy and/or renal biopsy Consider urine cytology iii.Persistent elevated liver function studies Consult with hepatology to determine need for further evaluation iv. Anemia/leukopenia/thrombocytopenia Consider evaluation by a hematologist Psychological/social factors i. Ability to independently consent without coercion as determined by Independent – Living Donor Advocate (ILDA) who evaluates each donor candidate and makes recommendations to team utilizing the Donor Advocate Psychosocial Tool ii. History of alcohol/drug dependence as determined by a mental health specialist – demonstrated abstinence and/or completion of a treatment program iii. Unwillingness to accept blood product- Absolute Contraindication 8. Infectious disease transmission i. HIV HIV is an absolute contraindication – ii. Hepatitis B HBsAg+ - absolute contraindication HBcAb+ - acceptable if PCR is negative for Hep B and if recipient is Hepatitis B immune. iii. Hepatitis C absolute contraindication – vi. Histoplasmosis acceptable if disease manifested by only calcified granulomas – vii. Tuberculosis Active TB is an absolute contraindication. All donors get a CXR – and candidates with an increased risk for TB infection undergo quantiferon gold testing. Positive immunologic screening tests requires an ID consult and clearance. viii. West Nile Virus Need to be negative for viremia by PCR during the peak –
PSA should be checked in males per American Urological Association screening guidelines (). Laboratory abnormalities – i. Proteinuria <180 mg on 24 hr urine is acceptable 181-250 mg – Order an albumin to Cr ratio on a spot urine. Patient may be a donor if value is < 0.03 >250 mg – not acceptable for donation ii. Persistent microscopic hematuria(UA x 2 with microscopy demonstrating > 5 RBC/ hpf). Proceed with the following evaluation: Cystoscopy and/or renal biopsy Consider urine cytology iii.Persistent elevated liver function studies Consult with hepatology to determine need for further evaluation iv. Anemia/leukopenia/thrombocytopenia Consider evaluation by a hematologist Psychological/social factors i. Ability to independently consent without coercion – as determined by Independent Living Donor Advocate (ILDA) who evaluates each donor candidate and makes recommendations to team utilizing the Donor Advocate Psychosocial Tool ii. History of alcohol/drug dependence as determined by a mental health specialist – demonstrated abstinence and/or completion of a treatment program iii. Unwillingness to accept blood product- Absolute Contraindication 8. Infectious disease transmission i. HIV – HIV is an absolute contraindication ii. Hepatitis B HBsAg+ - absolute contraindication HBcAb+ - acceptable if PCR is negative for Hep B and if recipient is Hepatitis B immune. iii. Hepatitis C – absolute contraindication vi. Histoplasmosis – acceptable if disease manifested by only calcified granulomas vii. Tuberculosis – Active TB is an absolute contraindication. All donors get a CXR and candidates with an increased risk for TB infection undergo quantiferon gold testing. Positive immunologic screening tests requires an ID consult and clearance. viii. West Nile Virus – Need to be negative for viremia by PCR during the peak