Living Donation
Deciding to give a kidney, an organ, and/or tissue after your life has ended is, in some respects, a relatively straight-forward prospect. But there can be numerous factors at play in the decision to donate a kidney now, and become a living donor.
As you contemplate becoming a living donor, the following facts may help you construct your plan. Please note: many of the items below include links for more information; these will take you to our national office's Kidney A - Z Health Guide.
What is living donation? Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person. The living donor can be a family member, such as a parent, child, brother or sister (living related donation). Living donation can also come from someone who is emotionally related to the recipient, such as a good friend, spouse or an in-law (living unrelated donation). Thanks to improved medications, a genetic link between the donor and recipient is no longer required to ensure a successful transplant. In some cases, living donation may even be from a stranger, which is called anonymous or non-directed donation.
Who can be a living kidney donor? To donate a kidney, you must be in good physical and mental health. As a general rule, you should be 18 years or older. You must also have normal kidney function. There are some medical conditions that could prevent you from being a living donor. These include:
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Uncontrolled high blood pressure
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Diabetes
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HIV
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Hepatitis
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Acute infections
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Having a serious mental health condition that requires treatment may also prevent you from being a donor
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To learn more, please click here.
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What are the advantages of living donation over deceased donation? Kidney transplants performed from living donors may have several advantages compared to transplants performed from deceased donors:
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Some living donor transplants are done between family members who are genetically similar. A better genetic match lessens the risk of rejection.
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A kidney from a living donor usually functions immediately, because the kidney is out of the body for a very short time. Some deceased donor kidneys do not function immediately, and as a result, the patient may require dialysis until the kidney starts to function.
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Potential donors can be tested ahead of time to find the donor who is most compatible with the recipient. The transplant can take place at a time convenient for both the donor and recipient.
Are there different types of living donation? There are two main types of living donation:
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Directed donation: This is when the donor names a specific person who will receive the kidney.It is the most common type of living donation.Directed donations are often between blood relatives, like parents, siblings, or children.They can also occur between people with close personal relationships, such as a spouse, friend, or coworker.
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Non-directed donation: This is when a person does not name a specific person who will get the kidney. In this case, the donor is matched with someone in need.
Are transplants from living donors always successful? Although transplantation is highly successful, and success rates continue to improve, problems may occur. Sometimes, the kidney is lost to rejection, surgical complications or the original disease that caused the recipient's kidney to fail. Talk to the transplant center staff about their success rates and the national success rates.
How long does a transplanted kidney last? On average, a kidney from a living donor lasts about 15 to 20 years. Some will last longer. For comparison: the average transplanted kidney from a deceased donor lasts approximately 12 years.
What do I need to consider before donating an organ? When you donate an organ to someone else, you are providing a life-sustaining gift. But there are many things you should consider carefully before you make the decision to become a living donor. You will need to consider your overall health, and whether you have any medical problems, such as high blood pressure or diabetes. You will also need to consider any effects donation might have on you, your spouse, your children, or other family members. Your finances are also important, such as time lost from work and travel expenses. In short, giving an organ to someone else means being ready to face some emotional, physical, and financial challenges. You should think about all of these things carefully and make sure you are willing and ready to donate.
Who pays for living donation? Generally, the recipient's Medicare or private health insurance will pay for the following for the donor (if the donation is to a family member or friend). Donors should always coordinate their tests with the transplant coordinator at the hospital in case there are any exceptions:
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Evaluation to determine if the person is a good candidate for living donation
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Donation surgery
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Post-operative care
However, the following expenses generally wouldn't be paid by either the recipient or the donor's insurance:
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Lost wages during the donor's recovery. Time off from work is not covered by Medicare or private insurance. However, donors may be eligible for sick leave, state disability and the Family and Medical Leave Act (FMLA).
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Travel expenses. If you are traveling to a transplant hospital away from home, you can incur expenses for travel, lodging expenses during evaluation and recovery, phone calls to home, childcare, etc. Some transplant hospitals offer free or low-cost hospitality houses for you and your family–be sure to ask about your options.
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Expenses for treatment of unrelated conditions that are discovered during the evaluation process
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Some follow-up expenses may also not be covered, so it's important to discuss these matters with the transplant center. The financial counselor and/or transplant social worker at the hospital can answer any questions you have about the cost of donation.
Will my health or life insurance coverage be affected by donation? Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.
However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.
If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.
If you are considering donation, talk to the financial counselor and social worker at the transplant center to find out if donation will affect your health or life insurance coverage. It is important for potential donors to carefully consider these issues before proceeding with donation.
You may also be able to acquire life insurance through the Living Organ Donor Network, which offers an option to donors to purchase life, disability and medical insurance for complications which might arise from being a kidney donor. The insurance is optional for transplant centers that participate in the Living Organ Donor Network data registry program as well as for individuals that may wish to benefit from this protection.
What does the surgery involve? In general, you will be given a general anesthetic in the operating room. You will be asleep and will not feel any pain during the surgery. In most cases, you and your recipient will be in adjacent operating rooms. One of your kidneys will be carefully removed and transplanted in the recipient. Typically, the surgery takes 3–5 hours with time in the recovery room afterward for observation. Removing your kidney may be done by laparoscopy or open surgery. The surgery to remove a kidney is called a “nephrectomy.”
If I'm a donor, what is my post-surgery recovery time? The length of stay in the hospital will vary depending on the individual donor's rate of recovery and the type of procedure performed (traditional vs laparoscopic kidney removal) although the usual stay is 4 to 6 days. Since the rate of recovery varies greatly among individuals, be sure to ask the transplant center for their estimate of your particular recovery time. After leaving the hospital, the donor will typically feel tenderness, itching and some pain as the incision continues to heal. Generally, heavy lifting is not recommended for about six weeks following surgery. It is also recommended that donors avoid contact sports where the remaining kidney could be injured. It is important for the donor to speak with the transplant staff about the best ways to return as quickly as possible to being physically fit.
How will donating a kidney affect my life and health? People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney. Physical exercise is healthy and good for you. However, someone with only one kidney needs to be careful and protect it from injury. Some doctors think it is best to avoid contact sports like football, boxing, hockey, soccer, martial arts, or wrestling. Wearing protective gear such as padded vests under clothing can help protect the kidney from injury during sports. This can help lessen the risk, but it won't take away the risk. Talk to your healthcare provider if you want to join in contact sports. Donors are encouraged to have good long-term medical follow-up with their primary care doctors. A urine test, a blood pressure check and a blood test for kidney function (GFR) should be done every year.