How can I become a living renal donor and what are the qualifications? How does living donation affect the donor? What are my rights as a donor? What are the advantages of living donation? What are the potential risks involved in living donation? What are the surgical techniques available to remove the donor’s kidney? What does the evaluation consist of? Who can be a living donor? Who pays for the renal evaluation and the surgery?


Question:

How can I become a living renal donor and what are the qualifications?

Answer

To be considered a potential living donor you must: 

  • Be 18 years of age or older;
  • Be free of uncontrolled high blood pressure, diabetes (including some instances of gestational diabetes), HIV, sickle cell disease, current malignancy or infection;
  • Not have had any heart attacks within one year;
  • Not have evidence of Hepatitis B;
  • Be in good general health, with acceptable kidney function;
  • Have a BMI of 35 or under;
  • Have acceptable anatomy for donation;
  • Not be pregnant;
  • Understand the risks, benefits and complications associated with donation;
  • Be willing to donate a kidney without monetary gain or psychological coercion;
  • Be willing to accept all blood and blood products the physician feels medically necessary;
  • Have a compatible blood and tissue type matching to the recipient as determined by blood testing;
  • Compatible blood types:

    Recipient's Blood Type   Donor's Blood Type
    O O
    A A or O
    B B or O
    AB A, B, AB or O
  • Not be incarcerated;
  • Not be an undocumented resident of the USA;
  • Be willing to consent for full disclosure of medical information;
  • Complete the renal donor evaluation to determine if you are a suitable donor. The purpose of these tests and consultations is to make absolutely certain you will not be harmed by donating.

Question:

How does living donation affect the donor?

Answer

Following kidney donation, the remaining kidney grows bigger and functions much harder. After the donor recovers from surgery, the donor can continue to live a normal life. The recovery for the laparascopic procedure is usually 2 to 3 weeks while the recovery for the open nephrectomy may take 4 to 6 weeks.  

After being discharged from the hospital, the donor should observe the following:

  • Avoid lifting more than 10 pounds for the first 6 weeks;
  • Increase fluid intake and walking to avoid constipation related to pain medications;
  • Take pain medications as prescribed by the physician;
  • Avoid NSAID’S such as Aleve, Nuprin, Advil , Motrin and Ibuprofen;
  • Have an adequate follow up with the doctor following laboratory tests;
  • Report any concerns to the transplant physician or coordinator.

Question:

What are my rights as a donor?

Answer

A potential living donor has the right to change his or her mind at anytime and the decision will be respected by the transplant team. The results of the evaluation are strictly confidential and are not shared with anyone except the potential donor.

Question:

What are the advantages of living donation?

Answer

A living donor kidney transplant has many advantages as compared to a transplant from a deceased donor.

  • Donors can be tested as soon as the recipient is actively listed, negating the prolonged wait for a deceased donor.
  • A kidney from a living donor typically works better and has a longer life span.
  • The surgery can be pre-scheduled, avoiding the uncertainty and stress of being on the waiting list.
  • May prevent the need for dialysis and the complications associated with kidney failure.
  • Living donor kidneys typically begin to function immediately.
  • For some patients with kidney failure, a living donation may be life saving.
  • Choosing to donate a kidney is a gift of life.

Question:

What are the potential risks involved in living donation?

Answer

Donating an organ requires major surgery. There are risks associated with the surgery and potential complications from the general anesthesia. Modern science and current medications used in surgery make the risk of complications very low. Many complications are minor and get better on their own. In some cases the complications are serious enough to require another surgery or medical procedure.

Some of these medical risks may include allergic reaction to the general anesthesia, bleeding, infection, injury to structures in the abdomen, and pressure sores on the skin or burns caused by the use of electric equipment during surgery. Damage to nerves may occur and death from kidney donation is very rare. Psychosocial risks may include depression, anxiety, post traumatic stress disorder and feelings of guilt.

Question

What are the surgical techniques available to remove the donor’s kidney?

Answer

Laparascopic surgery is a specialized, less invasive procedure in which the surgeon places a small wound in the donor’s abdomen for a camera and surgical instruments and to remove the kidney. Laparascopic nephrectomy has better cosmetic results, usually has a quicker recovery period and a more rapid return to normal activities. Pain medications are generally needed for a shorter time.

Sometimes the donor is not a candidate for laparascopy because of the donor’s anatomy or surgical history. In this case an open approach, called Open Nephrectomy, is used to remove the kidney. With this procedure, the surgeon makes an incision in the side or flank area which is larger than what is made during the laparascopy. There is generally more pain and a longer recovery associated with this procedure.

Question:

What does the evaluation consist of?

Answer

  • Living Donor Coordinator/Independent Living Donor Advocate Consult: This meeting is intended to fully inform the potential donor about the kidney donation and the transplant process.
  • The doctor carefully assesses the function of the kidneys and the safety of donating.
  • Transplant Surgeon: The surgeon discusses the appropriateness of donating a kidney, the risk of surgery and possible complications after donation.
  • Social Worker Consult: A psychosocial assessment is conducted to evaluate the potential donor’s readiness to donate a kidney.
  • Registered Dietician Consult: The dietician may perform a nutritional assessment and provide nutritional education.
  • Health exam: Several tests are done to determine if the potential donor is a suitable candidate including:
    • Laboratory testing to screen the immunity for presence of viruses. Blood and urine tests help determine if all organs, including the kidneys, are healthy and functioning properly.
    • A chest X-ray to help identify any problems with the lungs and an EKG (electrocardiogram) to assess heart function.
    • A CT scan to examine the abdomen and pelvis area and to determine which of the donor’s kidneys is best for donation.
    • A Pap smear exam and mammogram for women over the age of 40 to evaluate any presence of malignancy.
    • A PSA for all men over the age of 50 to evaluate the prostate.

Question:

Who can be a living donor?

Answer

Donation does not have to be from a blood relative. Our living donor program is available to anyone who is medically and psychologically suitable for donation. A living donor can be:

  • Family, friend, spouse or coworker;
  • A directed altruistic donor (someone who donates a kidney to a specific person with whom he or she might be acquaint
  • ed);
  • A nondirected altruristic donor (someone who donates a kidney to a non-specific person on the waiting list);
  • A donor through the Paired Donor Exchange program or “Kidney swap.” This is a person who is willing to donate but is incompatible to the intended recipient. Baylor St. Luke’s Medical Center, sponsored by the National Kidney Foundation program, offers the donor and the recipient the opportunity to match one incompatible donor/recipient pair to another pair. In other words, the two donors donate to the other’s recipient. For more information, you may reach the living donor coordinator at 832-355-5506.

Question:

Who pays for the renal evaluation and the surgery?

Answer

In most cases the cost of the renal donor evaluation is paid by the recipient’s insurance and there is no cost to the donor. However, the donor is not reimbursed for missed days at work, travel or lodging. Donors should look into whether their short term disability insurance covers the recovery. The National Living Donor Assistance Center may provide financial support to persons who want to donate, but cannot otherwise afford travel and expenses associated with donation. For more information on how to apply, please visit LivingDonorAssistance.org.