Answering Your Questions About Kidney Donation

The kidneys are two of the body’s most important organs. They filter waste, release hormones that control blood pressure and help make red blood cells and vitamin D.

When they don’t work, treatment is needed to stay healthy — and sometimes that means getting a kidney transplant from either a living or deceased organ donor.

In line with National Donate Life Month, which occurs every April, we caught up with Licensed Clinical Social Worker Jennifer Laflen to answer some of the most common questions about kidney donation.

Q: Who can donate a kidney? 

A: Living kidney donors should be in good overall physical and mental health and be older than 18 years of age. Some donor health conditions could prevent someone from becoming a donor or harm a transplant recipient, so it is important to share all information about your physical and mental health.

The criteria for living donors varies by each transplant center, so allow the transplant center to decide if a potential donor is eligible to donate. Donors must be fully informed of the known risks involved with donating and complete a thorough medical and psychosocial evaluation. Any decision to donate must be completely voluntary and free of coercion, pressure or guilt. Donors can delay or stop the process of donation at any time, even while entering the operating room for the donor surgery.

Q: What is a living-donor kidney transplant?

A: This is when a kidney from a living donor is removed and placed into a recipient whose kidneys no longer function properly. Only one donated kidney is needed to replace two failed kidneys. Both the donor and recipient undergo a complete physical with the most advanced types of tests before approved for transplant. Once approved, the transplant surgery is scheduled and the kidney donor and the kidney recipient head into the operating room where one entire kidney is removed from the donor and transplanted into the recipient.

Q: What are the various kinds of kidney donation? 

A: There are three types of donation:

1. Directed donation: The donor names the specific person to receive the transplant, like a relative, a spouse or a friend. This is the most common type of living donation.
2. Paired donation: If tests show that a donor is not a good match with their recipient, they may be able to donate through a paired donation. This option allows multiple living kidney donor/transplant candidate pairs to swap living donor kidneys, so each recipient receives a compatible transplant.
3. Non-directed donation: In non-directed donation, the donor does not name the specific person to get the transplant. The match is arranged based on medical compatibility with a patient in need. Some non-directed donors choose never to meet their recipient and some recipients choose not to meet their donor. In other cases, the donor and recipient may meet at some time, if they both agree and if the transplant hospital policy permits it.

Q: What’s involved in the surgery and recovery? 

A: After an extensive evaluation, the transplant team will decide if a donor is approved for donation. Once approved for donation, the surgery is scheduled when convenient for the recipient and the donor. Often teachers or college students choose to donate in the summer when out of school. Others donate over holidays when they have time off.

Surgery is done laparoscopically, which typically means smaller incisions, faster recovery and less pain. Living kidney donors are usually discharged 1-2 days after surgery and a full recovery takes 4-6 weeks, although most donors can return to work 1-2 weeks after donation.

Q: What, if any, are long-term risks of kidney donation?

A: After donation, kidney donors can go on to live normal, healthy lives. They can return to regular activities, including sports and exercise, at 4-6 weeks after surgery. Female kidney donors should wait 3-6 months after donation to become pregnant, as the body needs time to recover from surgery and adjust to living with one kidney before pregnancy. There is a greater risk of dehydration with one kidney, so alcohol should be used in moderation.

Long-term medical and surgical risks include scars, pain, fatigue and other consequences typical of any surgical procedure, decreased kidney function for the donor, kidney failure and the need for dialysis or kidney transplant for the donor. Living donors will continue to receive follow up care at their transplant center for at least two years after donation to closely monitor and address any changes in health. If a living kidney donor later develops kidney failure, they are expedited to the top of the waiting list for transplant.

Q: Who pays for kidney donation? 

A: All living donor evaluation costs, surgical costs and immediate follow up visits are paid by the recipient’s insurance, including Medicare. The donor will pay for their medications (e.g., pain medication, antibiotic, stool softeners) when discharged from the hospital after their surgery, which usually cost less than $50. The donor will be responsible for any follow-up office visit copays after the three-month surgical global period ends. (A global period is a period of time that starts with a surgical procedure and ends a period of time after the procedure.) The transplant center will help you apply for funds to assist with lost wages, travel costs and childcare during the evaluation, surgery and recovery period.

Q: If someone is interested in being a living kidney donor, what are the next steps? 

A: First, talk with your doctor, who can help determine that you are in good overall physical and mental health. Then, if you know a person that you would like to consider donating a kidney to, contact the transplant program where the person is listed. If you are interested in donating a kidney and do not have an identified recipient, you should contact the living donor team at the transplant hospital of your choice.

You will have an initial screening and then be scheduled for extensive testing during your evaluation. Some donors wait to tell their recipients that they are being evaluated until they know that they are approved to donate by the transplant team to prevent any disappointment while other donors tell their recipients immediately and journey through the process together.

Q: Is there anything else you’d like to share about kidney donation? 

A: Living donor kidney transplant is the best treatment option for most patients with chronic kidney disease. Success rates for kidney transplant are much higher with living donor kidneys because the kidney can be transplanted immediately after removal and start to function much quicker in the recipient.

Living donor kidneys function on average for 15 to 20 years — twice as long as kidneys from deceased donors, which last an average of seven to 10 years. Although living kidney donation is preferred, around 50% of donors who come forward are ruled out due to medical or psychosocial concerns. Surgery can be scary, but 90-95% of living donors say they would not change anything about their decision to donate.

If you’d like to save lives but aren’t interested in donating a kidney now, you can still help! Join the National Donate Life Registry at https://registerme.org/ and, at the end of your life, you can directly save and heal someone. The organs and tissues that can be donated are: kidneys (remember that there are two of them!), heart, lungs, pancreas, liver, intestines, corneas, skin, tendons, bones, nerves and heart valves.

For more information on living kidney donation, visit https://www.kidney.org/atoz/content/living-donation. To learn about how to find a living donor or to start the conversation, visit https://www.kidney.org/transplantation/livingdonors.