Kidney Donation For People With High Blood Pressure
Can I donate a kidney if I have high blood pressure?
Until recently, you could not donate a kidney if you had high blood pressure. But now, you may be able to donate if your doctor thinks you have a low chance of getting kidney disease in the future.
Each transplant center has its own rules about who can donate. During your donor evaluation, doctors will measure your blood pressure to find out if you can safely donate a kidney. Tell your doctor if you:
- Know your past blood pressure readings
- Take medicine for high blood pressure
You may be able to donate with high blood pressure if:
- Youre over age 50
- Youre able to treat your high blood pressure with only 1 medicine
You may not be able to donate with high blood pressure if:
- Youre young and have family members with kidney disease
- Youre African American and have higher blood pressure
What do I need to do if I have high blood pressure and want to donate?
You may need extra medical tests, such as:
- A blood pressure cuff worn for 18-24 hours to check your blood pressure every few minutes
- An eye exam
- A heart test
After you donate, youll need to see your doctor regularly to watch your long-term health, including:
- Watching your blood pressure levels
- Testing your kidney health
How does living kidney donation affect high blood pressure?
How can I find out my chances of getting kidney disease from high blood pressure?
Financial Aspects Of Living Donation
Many potential kidney donors have questions regarding the financial impact of becoming a donor. There will be both covered expenses and non-covered expenses associated with evaluation and donation that potential donors need to consider carefully.
Covered Expenses
The insurance of the intended recipient of your kidney covers the testing needed to see whether or not you can be a donor as well as the surgery and hospitalization needed for the kidney donation.
In general, some follow-up/post-operative care is covered, but not all. The extent of covered follow-up care will vary depending on your recipient’s insurance.
Non-Covered Expenses
In general, the following expenses are not covered by insurance, so should be considered “out-of-pocket” costs:
- Travel and hotel stay
- Elder care
- Follow-up costs
- Lost wages )
- Federal Employees 30 days paid leave for organ donation
- American Society of Transplantation’s list of organizations that provide paid leave
What Are The Requirements For A Kidney Transplant
If you have advanced kidney disease, you may be eligible for a transplant. You will need to be evaluated by a transplant center, which will do a number of tests to determine whether you are a good candidate for a kidney transplant. In general, qualifications for kidney transplant include having chronic irreversible kidney disease, being on dialysis now or being close to needing dialysis. You may be ineligible for a kidney transplant if you have an additional life-threatening disease, a history of chronic drug or alcohol abuse, or a serious psychiatric disorder.
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Why Might I Need A Kidney Transplant
You may need a kidney transplant if you have end stage renal disease. This is a permanent condition of kidney failure. It often needsdialysis. This is a process used to remove wastes and other substances fromthe blood.
The kidneys:
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Remove urea and liquid waste from the blood in the form of urine. Urea is made when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the blood to the kidneys.
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Balance salts, electrolytes, such as potassium and sodium, and other substances in the blood
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Produce erythropoietin, a hormone that aids the formation of red blood cells
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Regulate blood pressure
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Regulate fluid and acid-base balance in the body to keep it neutral. This is needed for normal function of many processes within the body
Some conditions of the kidneys that may result in ESRD include:
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Repeated urinary infections
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Polycystic kidney disease or other inherited disorders
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Glomerulonephritis, which is inflammation of the kidney’s filtering units
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Hemolytic uremic syndrome, a rare disorder that causes kidney failure
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Lupus and other diseases of the immune system
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Obstructions
Other conditions, such as congenital defects of the kidneys, may result inthe need for a kidney transplant.
There may be other reasons for your healthcare provider to recommend akidney transplant.
Who Covers The Cost Of Living Kidney Donation
The transplant recipients health insurer covers medical costs associated with donation. But insurance may not cover nonmedical expenses like missed work, child care, transportation and lodging. Be sure to check with your insurance company about exactly whats covered.
A note from Cleveland Clinic
Donating a kidney can save someones life, but its a big decision. Your healthcare provider can help you decide if youre a good candidate for donation and discuss your risks. Extensive test are done to make sure your health wont be compromised. The surgery is relatively safe.
You can register to be an organ donor at Donate Life America . In many states, you can also register through your local motor vehicle department.
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What Are The Types Of Living Kidney Donation
There are two kinds of living kidney donation:
Living related : Donation from parents and sibling.
Living unrelated: Donation from friends or from person who isnt related by blood to the recipient.
Different types of kidney donation include:
- Directed: You choose who gets your donated kidney.
- Paired kidney exchange: Organ transplants work best when the donor and recipient have the same blood type or tissue type. If you and the recipient arent a compatible match, you can donate your kidney to someone else who is a match. In return, a family member or friend of the recipient donates a kidney to your loved one.
- Nondirected or altruistic: You dont know the person who gets the donated kidney. Instead, you choose to help someone unconditionally.
Can You Donate A Kidney If You Take Blood Pressure Medication
In the past, a BP reading > 140/90 mm Hg and/or use of antihypertensive medications was considered as contraindications to donation. However, patients with easily controlled hypertension with 1 or 2 agents and no evidence of target organ damage may be accepted as low-risk kidney donors on a case-by-case basis.
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Who Can Donate A Kidney
I’m often asked by someone if they can donate a kidney. It’s certainly not a simple yes/no answer. You need to be at least 18 years old and you’ll have to be evaluated by a transplant hospital….of course, you have to be healthy enough to donate. Sometimes hospitals are overwhelmed when many friends and family members contact them to be evaluated only to find out that many are ruled out after being asked just a few medical history questions.If you have a chronic illness, it is unlikely that you will be allowed to donate. A few of the health conditions that will usually preclude someone from donating are diabetes, high blood pressure, or a history of cardiac or respiratory problems. Being overweight or obese, or a family history of kidney disease may also preclude you from being considered. However, there isn’t a national standard used for evaluating donors, so you might be ruled out at one hospital, only to be accepted at another transplant hospital. If you have a health condition that precludes you from donating, you can still be helpful by becoming an advocate for the person in need. You can let others know about your friend or family members’ need for a transplant and educate them about the process. You’re advocating on their behavior is very credible since you wanted to donate, but were ruled out for medical reasons.
Can You Donate A Kidney If You Have Diabetes
Dr. Darla Granger, director of the St. John Transplant Specialty Center in Michigan, and a transplant surgeon, told Healthline that people with diabetes are ruled out as donors at her facility. If a person has high blood pressure and wishes to donate a kidney, they may be considered on a case-by-case basis.
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The Independent Living Donor Advocate
All transplant programs are required to identify an independent living donor advocate to potential donors. This person promotes the best interest of the potential living donor, advocate for the rights of the potential living donor and assists the potential living donor in obtaining and understanding information regarding:
- The consent process
- The evaluation process
- The surgical procedure
The benefit and need for follow-up in six months, one year and two years after donation.
The ILDA and or the donor coordinator will contact you six months, one year and two years after donation to check on your well-being and to obtain basic information about your health.
Hepatitis C Antibody Positive Donors
Hepatitis C antibody positive donor organs are only offered to hepatitis C positive recipients. Testing is done for strains of hepatitis C virus in the blood. The majority of patients with hepatitis C infections can be treated with medications after transplant to try to get rid of the virus.
To be offered a hepatitis C positive donor organ, patients must give consent ahead of time. Donors will be sent a consent explaining the risks and the benefits. Accepting a hepatitis C positive donor organ will not decrease the possibility of receiving an organ from any other donor.
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Comparison Of Living Donor And Deceased Donor Kidney Transplantations
The timeframes in this table are average estimates. Please speak to your kidney care team for more detailed information about how long your transplant might last and possible waiting times.
| Whats being compared? | ||
|---|---|---|
| Sometimes, but this is less likely due to the waiting time | ||
| Transplant surgery times can be planned in advance? | Yes surgery is usually during the day | No surgery often takes place at night |
| Chance of the transplanted kidney working within a day of the surgery | Higher. The kidney has come from someone who is fit and well, so it almost always works straight away. | Lower. The kidney has come from someone who has died, so it takes longer for the kidney to wake up and start working. |
| Risk from the donated kidney | Lower. The health of the donor is easier to thoroughly check before donation. The donor is unlikely to have had major health issues. | Higher. It is more difficult to thoroughly check the health of the donor, and because the donor is more likely to have had major health issues. |
Our Suggestions For Living Kidney Donor Evaluation With Respect To Bp
Based on the current literature, we suggest the following protocol in evaluating potential living kidney donors on the basis of their BPs .
Office readings should be carried out as recommended in most guidelines: patient will rest 5 minutes before readings are conducted. BP should be measured with a properly sized BP cuff. The final BP will be averaged over 3 readings conducted with a minimum of a 1-minute rest in between each reading. If there are additional concerns about a potential donors BP or younger age, overweight, or African heritage, then ABPM should be considered and measurements take place every 1530 minutes during the daytime and 3060 minutes at night for 24 hours with measurements.
Based on the most recent ACC/AHA guidelines, if the patient has an average office BP reading < 130/80 mm Hg over 3 measurements, then they should be considered for donation with appropriate individualization and counseling. If the patient has an average office BP reading 160/100 mm Hg, evidence of end-organ damage , or is taking > 2 antihypertensive medication, then they should be excluded from kidney donation.
With respect to BP assessment postdonation, we suggest maintaining a clinic BP 130/80 mm Hg, which is in line with current guidelines, not only for living kidney donors but for the general population. Whether patients who are obese or possibly carry high risk APOL1 variants require lower BP targets is an intriguing question.
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The Recovery And Aftermath
Recovery from a kidney donation operation can take from two to 12 weeks depending on the persons individual progress.
Traditional open surgery
If the operation was an open nephrectomy, you may be in hospital for five to seven days, but you should be out of bed the day after the operation. Surgeons use either stitches or clips to close the incisions they made during the operation and these will be removed around 10 days after the procedure.
Before you leave hospital, a follow-up clinic appointment will be made, usually for four to six weeks later. The scars from the operation may be sensitive or sore for several weeks, and some numbness around the scar is common. There will be a permanent scar. There may also be twinges or a drawing sensation around the scars for some months, but most people feel back to normal by about 12 weeks after the operation.
Keyhole surgery
If the operation was keyhole surgery, recovery time is shorter and there is usually less pain afterwards. After this type of surgery you will normally need four to six weeks of recovery time at home before resuming your normal activities. Painkillers may be needed for a while, depending on an individuals symptoms. You will be asked to come in for a follow-up appointment four to six weeks after the operation.
Psychological impact
Getting back to normal life
You should return to exercise gradually and gently and build up any exercise routine slowly.
Further reading
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What Are The Risks Of Being A Living Kidney Donor
Like any surgery, kidney donation carries the risk of surgical complications like blood clots and others, but these risks are low. You will lose a certain percentage of your kidney function after donation. This sounds scary, but after the surgery your remaining kidney will get bigger and you wont notice any difference.
Donating a kidney doesnt increase your future risk of kidney failure. However, if kidney failure occurs for whatever reason, UNOS has a priority system that ensures living organ donors are at the top of the waitlist and get it quickly. This happens very rarely.
Other risks of kidney donation include:
- Nerve damage .
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How Can I Donate
If you want to give your kidney to a friend or family member, talk to the doctor at the transplant center. You’ll start taking tests to see if you’re a match.
If you want to give a kidney to someone you don’t know, contact your nearest transplant center. You can find out if they have a nondirected donor program. If they don’t, ask your doctor for a list of centers that have an anonymous donor program. You can also find those programs online.
Show Sources
National Kidney Foundation: “How Your Kidneys Work,” “The Evaluation,” âHelpful Tips for Living Donors and Caretakers,â “What to Expect After Donation,” âGeneral Information on Living Donation.â
Johns Hopkins Medicine: “What Kidney Donors Need to Know Before, During and After Donating a Kidney.”
UCSF Medical Center: âFAQ: Living Kidney Donor.â
American Transplant Foundation: “Becoming a Living Donor,” “What to Consider Before Donating.”
National Kidney Registry: “Living Donors.”
UNOS: “Living Donation: Information You Need to Know.â
Can Someone Who Has Had Kidney Stones Donate A Kidney
hascan donatecankidneyhavekidney stonesHavekidney stones
. Besides, what disqualifies a kidney donor?
These include having uncontrolled high blood pressure, diabetes, cancer, HIV, hepatitis, or acute infections. Having a serious mental health condition that requires treatment may also prevent you from being a donor.
Additionally, can you drink if you donate a kidney? Myth #7: A kidney donor can no longer consume alcohol following donation. Fact #7: While excessive alcohol use is always dangerous, a kidney donor can consume alcohol in moderation. The body requires time to recover from the surgery and to adjust to living with one kidney prior to pregnancy.
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You may not be able to donate if: You have a high BMI. Cut-offs vary between transplant programs. You‘ve had weight loss surgery, such as gastric bypass or a gastric sleeve.
What happens if I donate a kidney?
Some living donors have reported that they have experienced problems with their health insurance after donating an organ. Possible long-term risks to donating a kidney include hyper-tension , hernia, organ impairment and the need for organ transplant, kidney failure, and death.
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What Is A Kidney Transplant
A kidney transplant is a surgery done to replace a diseased kidney with ahealthy kidney from a donor. The kidney may come from a deceased organdonor or from a living donor. Family members or others who are a good matchmay be able to donate one of their kidneys. This type of transplant iscalled a living transplant. People who donate a kidney can live healthylives with one healthy kidney.
A person getting a transplant most often gets just 1 kidney. In raresituations, he or she may get 2 kidneys from a deceased donor. The diseasedkidneys are usually left in place. The transplanted kidney is placed in thelower belly on the front side of the body.
What Are The Risks Of Becoming A Kidney Donor
Removing a kidney from your body involves major surgery. There is a risk of complications from surgery, such as pain, infection, pneumonia, and bleeding.
A person can live with only one healthy kidney. But doctors are learning that donating a kidney may increase the chance of certain health problems in the years after the donation. More research is being done to better understand the long-term risks.
Donating an organ can affect you and your family. Many emotional issues are involved. There may be costs such as travel expenses and lost wages. And organ donation may affect your insurance coverage.
If you are thinking about donating a kidney, your medical team will help you understand the pros and cons so you can make the decision that’s right for you.
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