Article Under Review
This article is undergoing editorial and medical review. We regularly update content as part of our commitment to providing patient-centered, accurate, evidence-based information.
Overview
Initial screening is your first step. A transplant coordinator calls or meets with you to gather basic information. They ask about your health, your current conditions, your medicines, and why you want to donate. For directed donors, they also check your blood type against your recipient's. If everything looks promising, you move on to a full evaluation.
This first conversation usually takes 20-30 minutes. It is not the full evaluation. The coordinator is just checking whether the next step makes sense. It is also your first look at the transplant center. Pay attention to how they treat you. Do they answer your questions and respect your time? How this conversation feels matters.
The first conversation
The screening process follows this general pathway:
- Initial phone or in-person screening with a coordinator
- Blood type testing
- Basic health checks to identify obvious contraindications
- Decision about whether to proceed to full evaluation
- Scheduling of formal evaluation if you're a reasonable candidate
This article explains what to expect during this crucial first step.
The first step
The initial screening is usually a phone call, though some centers schedule a first in-person visit. Either way, it's a conversation between you and a transplant coordinator or nurse. They're not evaluating you yet in the formal sense; they're screening you to see if formal evaluation is worth pursuing.
This is also your first chance to ask questions and get a sense of the transplant center. How do they treat you? Are they respectful of your autonomy? Do they pressure you or do they give you space to decide? Pay attention to how this conversation feels. You want to work with a center that respects you.
What the phone screening covers
The transplant coordinator will ask you about your health history during this initial screening call. They need to understand your medical background to identify any obvious contraindications to donation. The conversation typically takes 20-30 minutes, and the coordinator is gathering basic facts rather than conducting a deep interview.
Information the coordinator gathers:
- Your age, occupation, and general current health status
- Major medical conditions such as diabetes, hypertension, heart disease, or kidney disease
- Your current medications and any drug allergies
- Previous surgeries or medical procedures
- Family history of serious illnesses, particularly kidney disease, diabetes, or heart disease
- Your smoking and alcohol use patterns
- History of mental health conditions or treatment
The coordinator will also ask about your donation motivation—who is the recipient (if directed donation) and why you want to donate. For directed donors, they'll ask about the intended recipient's blood type and relevant medical information.
If concerns surface during screening—such as a serious heart condition, uncontrolled diabetes, or active substance abuse—the coordinator will let you know that you may not be eligible and will refer you to discuss this with a physician. It's better to identify these issues at this early stage than later.
Blood type and basic health
If the initial screening goes well, the center will likely schedule blood type testing. If you're a directed donor (donating to someone you know), your blood type needs to be compatible with the recipient's. If you're a non-directed donor, blood type is less critical—your organ will go to someone compatible.
Blood type compatibility follows specific rules that determine whether a directed donation can proceed without special protocols. Type O donors have the most flexibility—they can donate to anyone regardless of recipient blood type. Type A donors can donate to Type A and AB recipients. Type B donors can donate to Type B and AB recipients. Type AB donors can only donate to Type AB recipients.
Blood type typing and initial health checks:
- Blood type determination and initial lab work
- Blood pressure measurement
- Confirmation that you don't have obvious disqualifying conditions
- Preliminary assessment of organ suitability (kidney size, liver health assessment)
If you're blood type incompatible with your intended recipient, don't worry—you have options. The center will discuss paired exchange programs that match incompatible pairs with other pairs in the system. Some centers offer blood type incompatible transplantation protocols for recipients who meet specific criteria.
You can also choose non-directed donation, where your organ goes to someone compatible, and your intended recipient enters the paired exchange system to find a compatible donor.
This early screening is just preliminary. Full medical evaluation comes later if you pass this stage and move forward toward formal evaluation.
What happens after screening?
If the initial screening suggests you're a reasonable candidate, the coordinator will schedule a full evaluation. This move from screening to formal evaluation typically happens 1-4 weeks later, depending on the transplant center's schedule and volume. Before this transition, you'll have a chance to ask questions and discuss any concerns about the evaluation process ahead.
If you are a potential match
If the initial screening is positive and you're blood type compatible with your recipient, the center will move forward to formal evaluation. They'll schedule:
- Lab work (more extensive than the screening)
- Imaging (ultrasound to visualize your organs)
- Possibly an appointment with the evaluation coordinator or a donor physician to discuss what comes next
For directed donors, the recipient will begin their own evaluation simultaneously or will already be in evaluation.
If you are not a match
Blood type incompatibility doesn't end your donation journey. You have options:
- Paired kidney exchange: If the incompatibility is due to blood type, you might be eligible for a paired exchange program that finds a compatible pair.
- Blood type incompatible (BTI) transplant: Some centers perform blood type incompatible transplants, though this requires special preparation for the recipient.
- Non-directed donation: You can donate anonymously to someone compatible with your blood type, and your intended recipient can enter the paired exchange program.
The transplant center will explain your options. If directed donation doesn't work due to incompatibility, you're not stuck—alternative paths exist.
Your right to stop at any time
Before you go any further, remember: you can stop the process at any point. If you say yes to the initial screening, that doesn't commit you to anything. If you change your mind during evaluation, during surgery prep, or even the day before surgery, that's your right.
The initial screening is a two-way conversation. The center is evaluating whether you're medically suitable. You're evaluating whether this center and this process feel right to you. If something doesn't feel good, you can walk away.
Additional Detailed Information
Additional Information
Initial screening protocols and outcomes
Screening outcomes. Approximately 80–85% of potential donors who initiate screening proceed to formal evaluation. Approximately 15–20% are not advanced due to medical contraindications identified during screening or early laboratory work.
Positive predictive value. Donors who pass initial screening and have compatible blood type have >95% likelihood of proceeding through evaluation to surgery (excluding those who change their mind or develop new medical issues).
Blood type distribution. In the U.S., type O donors are overrepresented in the living donor pool relative to population prevalence. Type AB recipients are disproportionately affected by blood type incompatibility.
Coordinator role and training
Screening coordination. Transplant coordinators conducting initial screening are typically registered nurses with transplant-specific training. They follow structured screening protocols to standardize information collection and ensure critical health factors are identified.
Initial risk stratification. The coordinator's role includes identifying any obvious contraindications (active malignancy, severe cardiac disease, hepatic disease) that would preclude full evaluation.
Written By:
Transplants.org Staff
Last Reviewed: February 26, 2026
Informed By:
Transplants.org, with participation from 23 leading U.S. transplant centers, led the largest comparative analysis of patient educational materials in transplant history. We recognize the participating centers who helped inform and inspire our direction with initial patient-centered educational content:
- Mayo Clinic (Co-Author)
- Vanderbilt University Medical Center (Co-Author)
- Johns Hopkins Hospital (Co-Author)
- UCLA Medical Center (Co-Author)
- UCSF Medical Center (Co-Author)
Transplants.org is an independent nonprofit organization and participation is not an endorsement by these organizations.
