- A live donor kidney has better results
- Live donor kidneys last twice as long
- A living donor transplant will eliminate the long wait time on the transplant waiting list
- It is a planned procedure which can be timed for the optimal health of the recipient and for donor convenience
The recipient will be on the deceased donor waiting list. There may also be other potential living donors. The recipient also has the option of hemodialysis or peritoneal dialysis.
Potential living donors can be related (family members) or non-related (friends, co-workers, church members etc.).
If the recipient has applied to the Baylor Annette C. and Harold C. Simmons Transplant Institute, the first step is to complete the confidential online health history questionnaire. Once you have completed this questionnaire, your information will be reviewed by a Baylor living donor coordinator. If you are a possible candidate, the coordinator will contact you to review your health history and answer any questions you may have.
If the recipient has applied to the Methodist Dallas Medical Center, the donor must take the first step and call the recipient’s Pre-Transplant Coordinator before the donor process can begin. It is required that the donor submits an application, which will be sent to Methodist for financial approval. Most insurance companies do pay for donor medical evaluations; however, there are some that do not. If the insurance company denies financial approval, it will be necessary that the recipient make a cash deposit for the evaluation.
Not everybody can give a kidney for donation. Donors need to be healthy individuals with two normal kidneys, compatible blood type with the recipient, and the tissue typing crossmatch must be negative.
The evaluation for a living donor is very similar to the evaluation for the recipient. This is a very thorough medical and psychological evaluation. The results of the living donor’s medical evaluation will also be presented to the Transplant Committee of the Transplant Center. The Transplant Committee will then either approve or disapprove the living donor as a candidate for donation of their kidney.
Donor evaluations also take varied times, depending on the individual and his/her medical condition. Only one donor at a time will undergo medical evaluation. An estimation of the length of time that is required for the donor’s medical evaluation is approximately one month. After the completion of the medical evaluation, the donor test results will also be presented to the Transplant Committee. If the living donor is approved, a transplant date can be scheduled at a time that is mutually convenient for the recipient, donor, Transplant Center, Transplant Surgeon, and donor surgeon. (The transplant date is usually four to six weeks following the committee approval).
Issues that would prevent someone from donating include:
- Hypertension or high blood pressure
- History of cancer or current cancer
- Kidney stones, recurrent kidney infection or history of surgery on the urinary system
- HIV positive
- Overweight as to jeopardize their health
- Severe heart, lung or vascular problems
- Unresolved stomach ulcers
- Psychosocial issues that do not meet criteria guidelines
There are two types of surgical procedures for obtaining the donor kidney:
- The donor will have an incision in his/her side just under the ribs.
- Average hospital stay is 5 to 7 days.
- Usual recovery time is 4 to 6 weeks.
- A fiber optic instrument is inserted through small incisions in the abdomen to visualize the surgical removal of the donor kidney.
- Average hospital stay is 2 to 3 days.
- Usual recovery time is approximately 10 days less than with open nephrectomy.
The donor surgeon will explain these procedures to the donor in detail so that the decision can be made as to which procedure is the best option for the donor.
The risks for donating a kidney are greatly reduced because of careful medical evaluation before donation. Risks may still be present as in all surgical procedures. These risks will be discussed in detail with the potential donor when the patient is seen both by the transplant nephrologist and the donor surgeon.
After surgery for removal of the kidney, the donor is at risk for:
- wound infection
- blood clots in the legs
- internal bleeding
Though the risk factors are very low, you need to be aware of them. If the donor’s remaining kidney is injured in an accident or becomes diseased, the donor will no longer have a second kidney and may even need dialysis or transplantation.
The donor evaluation process will be kept confidential. No information will be given to the potential recipient without prior approval of the donor. Donors are strongly encouraged to have individual health insurance. This recommendation is based on the possibility that the donor’s ability to obtain insurance after donation may be more difficult. Donors should be aware that future health problems related to the donation may not be covered. These factors should be thoroughly considered prior to donating.
Finally, donors have the right to stop the donation evaluation process at any point along the way for any reason.
If the donor has had an open nephrectomy, the donor will have a larger incision than if he/she has laparoscopic surgery. Pain medication will be available after surgery for the discomfort. The nurses will remind the patient to breathe deeply and cough frequently. This helps prevent pneumonia. The donor will be getting out of bed soon after surgery to help prevent lung and other problems.
To make sure that the donor receives adequate fluids and nourishment, intravenous fluids will be given until normal oral intake is established.
A catheter will be placed in the bladder for 24 hours after the surgery.
The donor will usually not need a special diet, although it is strongly advised that the donor eat a well balanced diet. An iron supplement may be needed for a short time, but it will not be necessary for the donor to take medications because he/she donated a kidney.
The donor should avoid non-steroidal anti-inflammatory medications (i.e.: Motrin, Ibuprofen, Aleve, etc.) and certain antibiotics. We recommend that donors thoroughly discuss any medications with their doctor prior to taking.
Donors should also make sure that they drink lots of water and do not allow themselves to get dehydrated.
Yes. Let your coordinator know that you are interested in nutrition related to your surgery.
You and your recipient may be eligible for the Paired Donor Exchange Program. This program allows you to donate to another recipient who was not compatible with their donor and then their donor would donate to your recipient.
If you are interested in the option, please discuss it with your transplant coordinator. You may also obtain information at the Alliance for Paired Donation website.
Generally within one to two weeks following the surgery the surgeon will see the donor again as an outpatient in their office. If the donor is from out of the Dallas area and is healing well without problems, the surgeon will release the donor to go home.
Yes, the donor will need to have a follow-up visit three months after the surgery to see the transplant nephrologist for a follow-up evaluation. It will also be necessary for some follow-up testing which will include a CBC, routine blood chemistries, urinalysis, urine culture, 24-hour urine for protein and creatinine, and a Glofil test. The recipient’s insurance will pay for these follow-up tests.
It is recommended that the donor have annual follow-up examinations with their primary care physician. This examination may include a urinalysis, routine blood chemistries and blood pressure check. The donor will be financially responsible for the annual follow-up examinations.
There are usually no restrictions to activity. Some physicians may recommend that the donor refrain from contact sports following the donation of a kidney.
In order to comply with UNOS data collection requirements, donors will be contacted by the Pre-Transplant center at 6 months, 1 year and 2 years post donation to answer a short set of questions regarding the donor’s current health status. You may be asked to go to your primary care physician to have blood pressure checked, urinanalysis for protein and a renal panel blood test if you are out of town or you may be asked to have these test performed at the transplant center. UNOS requires this data for donor follow-up.