Tests you may need before transplant surgery

You may need some special tests, depending on your age and health. These types of tests include a mammogram for women, heart stress test, colonoscopy.

The transplant coordinator can tell you which tests you need.

If your tests show any abnormal results, you may need follow-up tests or treatment. For example, if you have a heart problem and your stress test is positive, you may need to meet with a cardiologist (heart doctor).

Blood typing (ABO compatibility)

Blood typing is the first blood test that must show your blood and the donor's blood is compatible. 

If your blood type works with the donor's blood type, you will take the next blood test (tissue typing). If your blood type does not work, you will not be able to receive a kidney. The transplant coordinator can help provide support for you, if needed.

Blood is made up of four parts:

  • red blood cells (carry oxygen to your organs and tissues)
  • white blood cells (fight infection)
  • plasma (has salt, proteins and water)
  • platelets (help blood clot).

A simple blood test can tell your blood type. The four basic blood types are A, B, AB and O. (Type O is the most common blood type and anyone of any blood type can accept type O.)

Your blood type Blood types from which you can accept a kidney




A or O


B or O


A, B, AB or O

AB is the universal recipient blood type. If you have an AB blood type, you can receive a kidney from anyone. The Rh factor ( or -) of blood does not matter in a transplant.

Tissue typing 

Tissue typing is a blood test that matches the number of antigens (genetic markers) the donor and recipient share. These antigens can recognize the difference between two people's body tissue.

Each person has six basic tissue typing antigens shared equally from their parents. The markers help tell which donor will be the best match between the recipient and donor. A parent and child would have at least 50 percent match while siblings could have a zero to 100 percent match.

The best match for the recipient is to have six out of six antigens match. (This is known as a zero mismatch.) It is possible for all six genetic markers to match.

It is not necessary that you match your antigens for a successful transplant. Even matching one antigen may make for a more successful transplant than matching five or six antigens from a deceased donor kidney.


Cross-matching is a blood test you and the donor will have at least two different times to see if you will react to the donor's kidney. If there is no reaction, the result is a negative cross-match. This means you can have transplant surgery.

You can pass all of your other tests, but if you have a positive cross-match, meaning your body would attack the new kidney, you cannot have surgery. If this happens, you can find another living donor or have your name placed on the deceased donor list.

Antibody levels 

If you are on the nationwide deceased donor list, you will need a PRA (panel reactive antibody) test. Antibodies are proteins made by your immune system to fight off bacteria and viruses.

A sample of your blood is tested with blood cells from 50 other people. If there is no reaction, the test is negative. This means the fewer reactions the lower the PRA, the better the chance you'll have of finding a match on the donor list.

If you have a high PRA level you may be placed in a special position on the waiting list. Even if you have a high PRA you may still get a kidney.

Source: Allina Health Patient Education, Kidney Transplant Information for Recipients and Donors, renal_ahc_93498
Reviewed By: Allina Patient Education experts, including the Transplantation Department of Abbott Northwestern Hospital
First Published: 05/15/2009
Last Reviewed: 05/15/2009

  • Talk with your transplant coordinator about scheduling your tests. You should have all of your tests done within about three months. Your transplant coordinator will receive all test results.
  • If a donor does not have a compatible blood type with his or her recipient, the Paired Donation Program could be an option. This program matches incompatible donors and recipients. Ask your kidney transplant coordinator for details.
  • An antigen is a genetic marker. Genetic markers are unique to your body.
  • A negative cross-match means you can have surgery. A positive cross-match means you cannot have surgery.
  • The higher your antibody levels, the higher the chance of your body reacting to donated kidneys.