Any patient at any time can refuse treatment, surgery, medication or anything else for that matter. (Court ordered treatment obviously will be an exception). Read your hospitals patient bill of rights. In addition, by you refusing to accept a donor should not penalize you on the wait list either. When a deceased donor kidney becomes available the organ is offered to the next eligible donor. The doctors ethically should inform the recipient of any known history regarding hypertension, behavior that may have placed the donor at an increased risk for communicable diseases such as hepatitis, HIV etc. I would think they would weigh in on if they think the kidney would be an appropriate and healthy match for the patient but ultimately it is always up to the patient to decide if they want to accept the organ.
In terms of living donors, there is not reason why you should not be able to refuse an organ. However, you may want to seek the advice of experienced health care providers to make sure that the reason you do not want to accept the organ is valid and based on evidence, not just hearsay or something you think might make an organ less desirable etc. If you have the time to explore options of living donors it makes sense to see who would be the best match and most medically and psychologically best fit donor. The issue comes up in some hospitals that they will only test one donor at a time due to the cost. I remember when I was testing for my recipient I asked the nurse coordinator at the original hospital what would happen if I decided to stop the process to see if another donor would become available. If then it was revealed that I was the better match or no one else matched could I then reopen my file. She told me, once I declined my file would not be reopened. I just assumed that was a universal rule or some type of standard protocol. Apparently, it wasn't and what I have found since, is that each hospital follows their own guidelines. There are not standards of protocol unfortunately. So I kept going in the process because I thought that I couldn't take the risk to stop. Apparently, the hospital where I ultimately had my surgery did not follow that rule but I found that out much later.
Good luck finding an appropriate donor and keep us posted on what you find out. Always amazes me how different institutions run their programs.
Sherri