Risks And Benefits Of Living Kidney Donation
People who are considering becoming a kidney donor must carefully weigh the potential risks and benefits of donating a kidney.
Although the surgery itself is often a major component of this decision, other factors such as medical risks, the cosmetic result, and socioeconomic factors also play an important role in the decision-making process, as described in detail in this section.
What Happens When Kidneys Stop Working
The kidneys remove waste products from our blood. They also control the levels of salt and fluid in our bodies. Sometimes an illness or a disease, such as high blood pressure or diabetes, can cause the kidneys to fail. When this happens, it is called end-stage kidney disease, because the kidneys are nearing the end of their ability to work correctly.
When the kidneys stop working, the patient must have some type of treatment to remove the waste products from the blood. One option is a kidney transplant. The kidney can come from a healthy living person or from someone who has recently died . Dialysis is another option. Dialysis uses a machine to remove waste products from the blood. For those who are eligible, transplant from a living donor is the best option.
How does living kidney donation work?
A person who donates a kidney to someone in need is called a living donor, and a person who needs a kidney is called a transplant candidate.
Any adult who is in good health can be assessed to become a living donor. Every potential donor must have a complete medical checkup to make sure they are healthy enough to donate a kidney to a person in need.
Types of living donation
This type of donation occurs when a potential donor knows a transplant candidate and is a match to that person. Directed donors can be biologically related to the transplant candidate or unrelated .
Non-directed anonymous donation
What are the advantages of living kidney donation?
Will I Be Able To Obtain Insurance Coverage After Donation
Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.
However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.
If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.
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Work With Your Medical Team
Your surgeon or donor coordinator will schedule a follow-up for you. It usually takes place a few weeks after surgery. âThat appointment is really important, so donât delay or skip it,â says Tim E. Taber, MD, the medical director for kidney transplantation at Indiana University Health.
You should also see your doctor at least once a year. âHeâll check your urine and blood to see how your kidney is doing,â Taber says. âHeâll also screen for problems like high blood pressure and diabetes, which can contribute to kidney disease.â
If you notice blood in your urine or unusual swelling , see your doctor right away. Those may be signs your kidney isnât working right.
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 .
The Financial Consequences Of Donation
Most discussion of the financial impact on living donors focuses on the time before and around the time of donation. But are there longer-term financial consequences of having one kidney? Many LDO visitors have said the answer is yes, and research into the issue confirms it.
Most frequently, the impact takes the form of denial of insurance or higher premiums for coverage. Donors have reported problems when purchasing health, life, and disability insurance. The lack of long-term health research and the failure of the medical community and insurance companies to agree on the long-term health consequences of donation contribute to the problem. For example, some insurance companies consider donation a preexisting condition or believe having one kidney puts the donor at greater physical risk, even when the donors physician attests to the good health of the donor.
However, problems with life and disability insurance continue. One study showed one out of four living donors were denied coverage or charged a higher premium for life insurance.
In the U.S., several states have enacted insurance protections for living donors that include life and disability insurance. A list of states and the status of those protections is maintained here by the American Kidney Fund. There is also proposed federal legislation to prevent insurers from denying coverage or charging higher premiums to living donors. However, despite bipartisan support, the bill has not moved toward passage.
Faq: Living Kidney Donor
Most kidneys for transplant are from people who have died and whose families give permission for organ donation. But there aren’t enough of these organs for everyone who needs one. Nationally, more than 70,000 patients are on the kidney transplant waiting list, and more are added each year.
Living donor kidney transplants are an important option. They’re possible because we’re born with two kidneys. When surgeons remove one of the donor’s kidneys, the remaining kidney grows slightly to compensate for the loss of the other and the kidney can function normally.
Here are some questions and answers about living donor kidney transplants:
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Answers To Common Questions
The team looking after you is not able to contact living donors on your behalf. If you would like a kidney transplant from a living donor, you will need to talk to family and friends and ask if they are interested in giving you a kidney.
Your doctor can advise on ways to do this.
- Living donors are often blood relatives. But they can also be a friend, family member, or partner
- They do not need to be the same age, blood group or tissue type as you
- Living donors must be aged 18 years or older, and be in good health
Yes. If you have a living donor but they have not yet finished all their tests , you can join the transplant waiting list for a deceased donor kidney.
However, usually once you have been given a date for your transplant operation from the living donor your name will be taken off the national waiting list.
If you are offered a deceased donor kidney but you have a potential living kidney donor who is close to completing their tests, you will need to discuss your options with your kidney transplant team. They will advise you on the best thing to do.
What Can I Expect During Kidney Donation Surgery
Surgeons typically remove a donated kidney using a minimally invasive laparoscopic procedure. Surgery to remove a kidney may take two to three hours. Your surgeon will:
- Make several small abdominal incisions.
- Insert a laparoscope into an incision.
- Use tiny instruments to remove the kidney through an incision.
- Close the incisions with dissolvable stitches.
Some cases are done open if there are anatomic issues, but this happens in less than 5% of the surgeries.
Often your kidney recipient will be in a nearby operating room in the same hospital. Another team of surgeons operates on the recipient.
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Recovery At Home And Follow Up After Living Donor Kidney Transplantation
Patients who have had surgery to donate a kidney are given painkillers immediately after the operation and when they are discharged from hospital, to use during their recovery period. Some people may also be prescribed antibiotics for a short period if they need them. However, living donors do not need any long-term medication as a result of kidney donation.
What Really Happens When You Donate A Kidney
If someone you loved needed a kidney transplantation, would you donate one of your kidneys to them? How about a complete stranger, would you consider going under the knife to prolong a strangers life? Many of us say well donate. But, is it a genuine sentiment or something we say to sound loving and heroic?
Approximately 123,000 Americans are on a waiting list to receive an organ transplant. At least 101,000 of those people are waiting for a kidney transplant. That number may not sound unattainable. But, only 17,000 people actually receive kidney transplants per year, according to the National Kidney Foundation.
There are two types of kidney transplantations: those that come from living donors and those that come from non-living donors . A kidney transplantation from living donors lasts about five years longer than those from non-living donors, according to Barnes-Jewish Hospital.
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Is It Better For A Friend Or Loved One To Donate Rather Than A Stranger
Its not necessarily better, but sometimes its easier. Many of us would love to help a family member in need by donating a kidney. But we often see older adults who refuse to take a kidney from their willing son, daughter, or spouse. Theyd rather wait on the transplant list than put their family member at perceived risk.
Unfortunately, people often have to wait several years on the transplant list to get a kidney. Every year, 4,500 people die while on the kidney transplant waiting list, according to data from the Living Kidney Donor Network. One bad infection while a patient is on dialysis can cause an illness from which he or she wont recover.
Living kidney donation is an incredibly selective and safe process. Fewer than 4 percent of living donors from 2006 to 2008 experienced complications that required medical intervention or hospital admission six weeks after donating.
We simply dont allow people to donate their kidneys if we think their future health will be at risk, even if the recipient is someone they really love. In fact we do not meet the potential recipients to keep the entire evaluation process entirely separate from him or her. This is to avoid any conflict of interest which could impact the decision on the donor eligibility. My No. 1 focus in my role on our transplant nephrology team is the safety of the donor. We determine who can safely donate through our rigorous application process.
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.
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.
Getting back to normal life
You should return to exercise gradually and gently and build up any exercise routine slowly.
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Who Can Have A Kidney Transplant
Most people who need a kidney transplant are able to have one, regardless of their age, as long as:
- they’re well enough to withstand the effects of surgery
- the transplant has a relatively good chance of success
- the person is willing to comply with the recommended treatments required after the transplant such as taking immunosuppressant medication and attending regular follow-up appointments
How Will I Pay For A Transplant
Medicare covers about 80% of the costs associated with an evaluation, transplant operation, follow-up care, and anti-rejection medicines. Private insurers and state programs may cover some costs as well. However, your post-transplant expenses may only be covered for a limited number of years. Its important to discuss coverage with your social worker, who can answer your questions or direct you to others who can help.
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Wallee Felt A Bit Isolated At First Though The Environment Was Perfect For Recovery He Could
I went through a period of, it was kind of isolation because, even when I came back to this house, his friends were actually abroad on holidays. So we were in the house alone with somebody caring for us.And so it was just a totally new experience. The neighbourhood we lived in was very quiet, perfect. Beautiful, comfortable, low house with a big garden. So it was easy to sleep and relax and rest. Then the people whose house we were in returned from their holidays. And I got on with them very, very well, and I just continued to make progress, you know walking the dog, just going for walks and eating, sleeping, resting. And eventually the doctor gave me permission to travel. And I flew to Copenhagen for a week and then I went to Greece for two weeks. And I stayed in my friends house because he was still recovering. So I actually stayed in his house in Greece, on this Greek island, and we spoke on the phone. So it was an unusual circumstance, but it was so, still if I think about it, it was so powerful.
Why Do Donors Need Health Insurance If The Recipient’s Insurance Pays For Everything
All donors are required to have health insurance in the event that any medical issues/diagnoses arise during the course of their evaluation to be a donor.
In this instance, the recipient’s insurance does not cover the donor’s medical expenses, so the potential donor must have health insurance in place to ensure that they will be covered in such a circumstance.
Kidney donation may also be considered a pre-existing condition. Although current law largely prohibits the denial of insurance based on pre-existing conditions, some insurance companies are still allowed to deny coverage for this reason. This is another reason why obtaining health insurance prior to donation is important.
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What Are The Side Effects Of Living With One Kidney
Some studies have indicated that there is a slightly higher chance of a small increase in your blood pressure or the amount of protein in your urine as a result of having one kidney. However, these are checked at annual followup and, if found, can be treated.
The overall risk of developing significant kidney disease in your remaining kidney after donation is very low, occurring in less than one in 200 donors, and it is much less in kidney donors than it is in the general population .
Whilst most women have uncomplicated pregnancies after donation, there is a slightly increased risk of gestational hypertension or pre-eclampsia.
Who Are The Ideal Candidates For Kidney Donation
Ideal donors can come from all walks of life. Sometimes complete strangers donate. The wait time to receive a kidney can be as long as five to eight years. In that time, a patients health can deteriorate, and they may not be well enough to undergo transplant surgery anymore. By knowing someone who they can receive a kidney directly from, the patients time spent on the wait time decreases dramatically. As long as the living donor is at least 18 years old and in overall good physical and psychological health, anyone can volunteer to be a living kidney donor.
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What Can I Expect After Kidney Donation Surgery
Youll stay in the hospital for two to three days. You may experience pain, tenderness or itching at the incision sites for few days. Fatigue is also common in the first few weeks.
Most people resume their usual activities within four to six weeks. After surgery, you should not:
- Drive for two weeks.
- Get pregnant for at least one year.
- Lift anything heavy for six weeks.
You should expect to do follow-ups with the team for two years.
Keep Up Your Healthy Lifestyle
âI was always health conscious. But before surgery, I started exercising more and getting serious about keeping my stress levels in check,â says Roberta Mittman, who donated a kidney to her sister in 2004.
Those healthy lifestyle habits stuck, says the New York City resident, whoâs now in her 60s. âTwelve years later, Iâm still going strong, as is my sister.â
As Mittman suggests, you should try to maintain a healthy lifestyle:
Drink alcohol in moderation . More than two to three drinks a day can damage your kidney and increase your risk of problems like high blood pressure.
Stop smoking . It damages all of your organs, including your kidneys.
Mind your meds. Talk to your doctor about all the medications you take, including over-the-counter pills and supplements. Some common medicines, like nonsteroidal anti-inflammatory drugs , may be hard on your kidney if you take them regularly or in high doses.
Eat well. You donât need to follow a special diet, even right after surgery. But nutrient-rich foods will help you keep your weight in check and lower your risk of high blood pressure and diabetes. That, in turn, will keep your kidney healthy. Some doctors think kidney donors should avoid eating too much protein, especially from protein powder or supplements. Thatâs because excess protein may make your kidney work harder.
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