In a living donor kidney transplant, surgeons remove one kidney from a living donor and transplant it into the recipient. Living donors are typically a family member or close friend but in some cases a living donor may give to a person they have never met.
The first living donor kidney transplant in the United States was performed in 1954 between identical twins. Since then, advancements in modern medicine have allowed living donor transplants to become increasingly prevalent.
In the case of kidney donations, there are the following types:
In directed donation transplants, the donor names the specific recipient who will receive the organ. The donor and recipient may or may not be related and do not have to have matching blood types, but are usually compatible for the transplant.
Non-directed donation occurs when the organ donor does not name the specific person to get the transplant. The match is arranged by the transplant hospital based on medical compatibility with a patient in need. The donor and recipient may or may not ever choose to meet each other.
Paired exchange donation
When a donor and recipient are not directly compatible for transplant, paired exchange donation allows two or more recipients to “trade” donors, allowing everyone to receive a kidney that is compatible with them.
The greatest advantages of living kidney donation are a shorter waiting time for the person needing the transplant and that the kidney tends to have more immediate function and lasts longer than a kidney from a deceased donor. More than 98% of transplanted kidneys from living donors are still working one year after transplant.
For the recipient of a living donor kidney transplant, this may mean:
- Dramatic improvements in the person’s quality of life, including less time on dialysis
- The ability to schedule the surgery for the optimal health of the recipient and donor
- A significant decrease in the amount of time the recipient is waiting for a transplant
- The opportunity for the living organ donor to make an immediate difference by helping to save a life
To be a living kidney donor at Scripps, you must be at least 18 years old and in good physical and mental health. Some medical conditions could potentially prevent someone from donating, including:
- Uncontrolled high blood pressure
- Acute infections
- Psychiatric conditions requiring treatment
Individuals who smoke or use nicotine will not be considered to become living organ donors.
As a potential donor, we ask that you share all of your health information with us and you will need to undergo a series of tests to ensure that it is safe for you to donate and that it will be safe for the potential recipient to receive your kidney.
Extensive medical testing and psychiatric evaluations are an early part of the process because there are risks associated with every surgery, including kidney donation surgery. The Scripps Living Donor team will also make sure that the person considering living donation is well-informed of the risks, benefits and potential outcomes for the donor and recipient, and is freely willing to donate.
If you are thinking about being a living kidney donor, our transplant team, our transplant team hospital staff can help find living donors who would be happy to share their experience with you. Organizations like the National Kidney Foundation and John Brockington Foundation can also put you in touch with someone who has been there. Some living organ donors and transplant recipients have shared their “Stories of Hope” with United Network for Organ Sharing (UNOS).
After completing the initial screening process, a physician from the Living Donor team will discuss the donation process with the potential donor at length before any procedures are planned or performed.
The evaluation process for a potential donor could take several weeks or even months to complete. Thorough health evaluations including blood work, imaging, and emotional and behavioral evaluations require potential donors to schedule several examinations and appointments.
In especially urgent cases, when a potential donor is highly motivated, these exams may be scheduled in close succession. In rare cases, the evaluation timeline may be condensed into as few as three or four weeks, depending on the donor’s health.
In addition to the information provided by members of our Living Donor team, potential donors also receive educational materials and access to support resources, including an Independent Living Donor Advocate.
The Independent Living Donor Advocate is not involved in the care of the potential transplant recipient; their main job is to look out for you and your interests during the donation process. The advocate supports your rights, including ensuring you have the time and information to decide whether living organ donation is right for you. They also make sure you have information regarding the consent and evaluation process; medical, financial and psychosocial risks; surgery; and recovery.
If you are approved for living organ donation, the surgery will be scheduled with the donor’s and recipient’s schedule in mind. Your organ transplant team will discuss your surgery and post-surgical care with you.
Many kidney donation surgeries are done laparoscopically, a minimally invasive technique which can provide patients with less discomfort and reduced risk of complications. While laparoscopic procedures are known to be safe, as in any surgical procedure, there are potential risks and complications, including infection, bleeding, tissue/organ injury and hernia. Your transplant team will discuss the risks and expected outcomes of your surgery.
Typically, a living kidney transplant donor spends two or three days in the hospital after surgery. As with any surgery, you will experience some pain and discomfort during recovery, which can be treated with prescribed or over-the-counter pain medication. Although recovery times vary, most donors can return to normal activity within four weeks after surgery and return to work in about six weeks, depending on the physical demands of their daily living and work tasks. You may not be able to drive for up to two weeks and may have lifting restrictions for at least six weeks.
To make sure that you continue to do well after donation, you will need follow-up tests to monitor your health. You will be asked to commit to this testing for up to two years after you donate. The Scientific Registry of Transplant Recipients national database contains statistics for every US transplant program, including outcomes data, types of transplants performed and number of transplants performed yearly.
The transplant recipient's health insurance generally covers the living organ donor’s medical expenses, which includes the donor’s evaluation, tests and surgery.
The transplant candidate’s insurance is not likely to cover other costs, such as:
- Medical care if your evaluation shows that you have a disease that you need to treat
- Long-term medical care if the donation causes you problems
- Follow-up health care for the rest of your life
- Lost income from the time the donor takes off from work to complete the evaluation, tests and surgery
Every health insurance policy is different when it comes to covering the medical expenses of donation. Be sure to ask questions about what medical costs might come up that may not be covered by insurance. Also, private and public funding resources may help cover your non-medical expenses. The Scripps Living Donor team will help you determine if you might qualify for these.
The National Living Donor Assistance Center can also provide additional information.
We recognize that becoming a donor is a big decision and we will help make sure you are comfortable moving forward and don't feel pressured to donate. Living kidney donation is a highly personal decision, and Scripps understands, respects and protects the health and rights of every potential donor.