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Living Kidney Transplant Program
"Donating a kidney to a loved one who has kidney failure can be a very positive experience for the donor, and many stories can be told about the heroic people who gave a loved one the greatest gift possible, the gift of life. "
What is living donation?
Living donation takes place when a person donates a kidney to a loved one in need of a transplant. The donor is most often a close family member, such as a parent, child, brother or sister. A living donor can also be a more distant family member, spouse or friend. Anyone interested in being a donor for you can come with you at the time of your appointment to be evaluated as a donor.
What is a living donor paired exchange?
Living donor paired exchange or living donor swap is when two pairs are incompatible, either by blood type or crossmatch, but match the other couple’s intended recipient. This allows two recipients to receive a life-enhancing organ and meets the desires of the donors who wish to donate. Below shows a diagram of how the exchange is performed. All four patients (two donors and two recipients) are in the operating room at the same time. As of December 2004, there were only 27 paired exchanges performed in the United States, the Hume-Lee Transplant Center is proud to be included in those numbers.
What is a living/deceased donor exchange?
Living/deceased donor exchange is a second advancement in transplantation. When a donor is incompatible with their intended recipient, they may still donate a kidney to someone on our transplant list. In turn, the donor’s intended recipient is given priority on the national waiting list, thereby reducing their anticipated waiting time for a deceased donor kidney. This benefits the donor by meeting the desire of donation and benefits all who are on the waiting list by removing one person. At the Hume-Lee Transplant Center, we have been performing this type of donation surgery since Fall, 2004. As of December, 2004, only thirteen of this type of donation had occurred in the United States and once again, the Hume-Lee Transplant Center is proud to offer this innovative opportunity to our potential kidney donors.
What are the advantages of living donation?
Living kidney transplantation has a number of advantages over kidney transplantation from a cadaver donor:
- Since the living kidney donor is usually a close relative of the person getting the transplant, there is a better chance of a good genetic match and less chance of rejection. As a result, living donor kidneys tend to last longer. In fact, living donor kidneys last twice as long as deceased donor kidneys. Lower doses of immunosuppressive drugs may be used with fewer side effects.
- The transplant can be scheduled ahead of time, something that cannot be done if you are on a waiting list for a deceased donor kidney transplant. This allows you to plan for absences from work, childcare, and other social concerns.
- Kidneys that come from living donors generally begin to function immediately after the transplant, while deceased donor kidneys may take several days or weeks before they begin to function normally. The kidney usually begins to work immediately, even in the operating room. There is a very low rate of Delayed Graft Function (DGF) in living transplants. A deceased donor kidney may not work right away for several reasons. This is known as acute tubular nephrosis (ATN)
or delayed graft function.
- While the national waiting time can be as long as six years, patients who have a living donor wait an average of just 88 days for their transplant! This may help assure that you are in better health than after a long wait and
reduce the potential decline in your health.
- Seventeen people die every day waiting for organ transplants. Living donation helps people waiting for deceased donor kidneys by lowering the number of people on the waiting list.
- Kidneys from living donors don't need to be transported from one site to another, so the kidney is in better condition when it's transplanted.
Who can become a living donor?
To qualify as a living donor, a person must be physically fit, in good health and free from high blood pressure, diabetes, cancer, kidney disease and heart disease. The donor is carefully evaluated by physical examination, tests to determine kidney function and studies to show the presence of two normal kidneys.
- Individuals considered for living donation are usually between 18-60 years of age.
- Gender and race are not factors in determining a successful match.
- The prospective donor and recipient must have a compatible blood type and crossmatch.
- The decision about whether to accept the donor is then made by the health care team at the transplant center.
How does living donation affect the donor?
Studies have shown that one kidney is enough to keep the body healthy by removing wastes and excess fluid from the blood. Living donation does not change life expectancy, and after recovery from the surgery, living donors can continue to lead normal lives. The usual recovery time after the surgery is short, and donors can generally resume their normal home and work activities within 2 to 6 weeks.
Suppose someone decides against being a living donor?
A decision to become a living donor is voluntary and should be free from internal or family pressures. Individuals have the right, after discussing and considering the facts, to decide that kidney donation is not for them. Likewise, people who have kidney failure have the right to decide that they do not want a transplant. The patient must live with the disease, and has the right to decide what is to be done. This decision, as well as the donor's, is respected provided it is made after a complete discussion of the available choices and possible results.
How much does living donation cost? Who pays?
The costs of the donation, which include laboratory, x-ray and doctors' and hospital charges, are paid by the recipient's insurance. There is no cost to the donor. However, the donor is not paid for time off from work, or travel expenses to or from the hospital and clinic. Some employers may allow this time to be taken as sick leave.
Are transplants from living donors always successful?
It is important to realize that, although living related kidney transplants are highly successful, problems may occur. Sometimes, the kidney is lost to rejection, or the original disease that caused kidney failure may come back in the transplant, causing it to fail.
Laparoscopic Donor Nephrectomy:
This new procedure has greatly improved the surgical experience for the donor. This surgery will leave the donor with 3 small scars and 1 large scar where the kidney is removed.
- The donor will have less pain and will recover more quickly
- The length of stay for the donor has been reduced to 1-3 days
- Many donors return to work within 2-4 weeks of the surgery
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