Kidney Donation Process Overview
Living donors are free to confidentially withdraw at any time during the donation evaluation process and are not obligated to donate.
To learn more about testing and living donation or learn more with our living donor education booklet and .
Selection Criteria For Living Donation
A standard set of selection criteria are used to determine if it is safe or appropriate for a person to be a living kidney donor. The following conditions must be met for a patient to be considered as a living donor at our Transplant Center.
- Body Mass Index less than or equal to 35.
- Normal blood pressure.
- Adequate psychosocial and financial support.
The following may prevent a candidate from being eligible for living donation:
- Less than age 18 or over age 65.
- Blood pressure outside an acceptable range.
- Abnormal glucose levels: fasting value greater than 100 or two hour tolerance greater than 140.
- History of gestational diabetes, cancer, autoimmune disorder such as lupus.
- Abnormal results from any requested testing.
- Infections or infectious diseases identified on work up such as hepatitis or tuberculosis.
- Unstable mental health conditions.
- Social or financial concerns identified by transplant team.
- Substance abuse.
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.
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How Do I Find A Living Kidney Donor
If you need a living kidney donor, you can sometimes find a donor by asking friends and family members. If you are unable to find a donor among people you know, we recommend finding a transplant center that participates in our Champion Microsite Program, which is a free service that helps kidney patients build a simple website to tell their story and find a donor. The site is sharable via social media and comes with 250 free business cards with the patients name and microsite URL that can be given out by the patient.
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Getting A Kidney Transplant When You Have Hepatitis C
You can still be eligible to get a kidney transplant if you have hepatitis C. When you have hepatitis C, your transplant team will consider:
- The health of your liver
- If your liver is badly damaged, you may not be recommended for a kidney transplant.
- In certain cases if your liver is damaged but you are healthy otherwise, you may be considered for a kidney and liver transplant at the same time.
If you are approved for transplant, your doctor might suggest you get a kidney from a person with hepatitis C, or from a person without hepatitis C.
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After I Donate A Kidney Will I Have Any Side Effects Or Health Problems
After you recover from the donation surgery, you should feel and be well. You can live with just one healthy kidney. Your remaining kidney will be able to do most of the work of both of your kidneys.
It is rare to have long-term physical problems from donating a kidney. But people with one kidney may have a higher chance of high blood pressure, which doctors may treat with medicine.
What Should I Eat Or Avoid Eating With A Kidney Transplant
You have more choices about what to eat after you receive a kidney transplant than you would if you were on dialysis. However, you will need to work with a dietitian to develop an eating plan that can change in response to your medicines, test results, weight, and blood pressure.
Read more about kidney failure and eating, diet, and nutrition.
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What Does The Operation Involve
The operation is different depending on whether it is an open surgery or by laparoscopy. Both start with an incision made in the persons side, the blood vessels to the kidney get tied off, and the ureter is tied off and the kidney is taken out. Typically, donors recover from laparoscopic surgery within a week and from the open surgery within a couple of weeks.
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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There Are Two Types Of Living Donation:
- Directed donation is when the living donor chooses the specific person with kidney disease who they want to donate their kidney to, such as a family member or friend.
- Non-directed donation is when the living donor does not have a specific person they will donate their kidney to. Instead, they donate their kidney to a stranger, such as through a paired kidney exchange program.
Giving The Gift Of Life
By becoming a live donor, you shorten the time a recipient spends on the kidney transplant waiting list . You also increase the likelihood of successful transplantation because survival rates are higher when the kidney transplant comes from a live donor. Additionally, you help another wait-listed patient because your donation vacates the recipients spot on the list for the next person when a deceased donors kidney becomes available.
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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. |
Effect On Your Future Health
If you donate a kidney, hospital staff must tell you about how living kidney donation relates to ongoing or chronic kidney disease and kidney failure. Your Independent Living Donor Advocate as well as the living donor nephrologist should help you understand these terms.
If you are thinking about donating a kidney, you should know that:
- On average, you will permanently lose 25-35% of your kidney function after donating.
- Your risk of having kidney failure later in your life is not any higher that it is for someone in the general population of a similar age, sex or race. However, you are more likely to have kidney failure than healthy people who are not donors.
- Chronic kidney disease most often starts in the middle of your life . Kidney failure most often starts after age 60. If you get tested when you are young, doctors cannot predict how likely you are to have chronic kidney disease or kidney failure later in life.
- If you damage your other kidney , you may have a higher chance of having chronic kidney disease, which could go on to become kidney failure.
- You will need medical treatment if you start to have kidney failure.
Current policy gives living donors priority on the national waiting list if they need to get a kidney transplant in the future. You can ask your Independent Living Donor Advocate or /Living Donor Coordinators about this policy.
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Becoming A Living Kidney Donor
To be a living kidney donor, you must be of good physical and mental health. You would typically be between the ages of 18 and 60 years, and you must be free of any diseases that could affect the health of the person receiving the kidney. A specialist medical team will test to make sure you are a matching blood and tissue type. A close match is more likely with genetically related donors.
Can I Donate A Kidney If I Drink Alcohol
Talk with your donor evaluation team to know if you can donate. In most cases:
- If you drink alcohol in moderation , you can likely move forward with donating a kidney.
- If you have issues with alcohol misuse, you may not be able to donate a kidney. Drinking too much alcohol can affect your overall health.
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What Happens When A Living Kidney Donor Needs A Transplant
Becoming a living kidney donor can be a heroic act, but it has its downsides: increased risks of health complications and occasionally, diseases that may create the need for the donor to have a kidney transplant later in life.
In recognition of these possible consequences, living kidney donors who are in need of a transplant have, since 1996, been given priority status to shorten their time on the waiting list.
But according to a study published Thursday in the Clinical Journal of the American Society of Nephrology, prior living donors do not always receive that priority status in a timely manner. Some had to wait for years and go through dialysis before moving to the front of the line while some possibly never got to priority status.
This is a big deal to donors and the transplant community, said Jennifer Wainright, an analyst at the United Network for Organ Sharing research department and the studys lead author. Living kidney donors should know that they are entitled to priority if they ever need a kidney, and also that most prior living donors receive their transplant quickly.
Wainright stumbled upon this issue when she was examining data on donors, waitlist candidates and transplant recipients from the national Organ Procurement and Transplantation Network for another project.
Because of the priority designation, most of these patients were able to receive transplants quickly, the study found. But a number waited a long time.
You Dont Have To Be Related To Someone To Donate A Kidney To Them
In fact, one in four living organ donors is not biologically related to the recipient . Spouses, in-laws, close friends, church members, and even members of the same community can all be living donors.
It’s true that family members have a higher chance of being a good match. But living donor transplants are more successful compared to kidneys from deceased donors because these kidneys come from living donors.
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Allograft Nephrectomy And The Chance Of Retransplantation
The rate of allograft nephrectomy before retransplantation ranges from 0.5 to 43% depending on the centres protocols . Some studies indicate an adverse impact of allograft nephrectomy on various clinical outcomes of a second transplant. In the cyclosporine era, a single-centre study demonstrated that allograft nephrectomy was associated with a significant increase in PRA levels, a higher incidence of DGF and reduced graft survival . In a retrospective single-centre study comparing 121 patients undergoing kidney retransplantation with preliminary allograft nephrectomy to 45 retransplant recipients without the procedure, allograft nephrectomy led to worse graft survival after retransplantation, with an increase in PRA levels, a higher rate of primary non-function and acute rejection pre-transplant allograft nephrectomy and PRA > 70% were independent and significant risk factors associated with graft loss after kidney retransplantation . Recently, in a retrospective analysis of 109 kidney transplant recipients, allograft nephrectomy was an independent risk factor for the development of DSAs and non-DSAs after 12 and 24months and negatively impacted the chance for retransplantation maintaining adequate immunosuppression is conversely a protective factor against allosensitization .
Receiving A Kidney From A Living Donor
A living donor is someone who has agreed to donate their kidney to you while they are still alive. This is possible as nearly everyone has two kidneys, but can lead normal healthy lives with just one kidney. A living donor will need an operation to remove one of their kidneys so it can be transplanted into you.
On average, approximately 30 out of 100 kidney transplants are from living donors.
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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.
Is There An Age Limit For Being A Living Kidney Donor
There is no official maximum age limit for becoming a living kidney donor. It is harder for an older donor to qualify for donation surgery but the National Kidney Registry has had donors who were in their late-70s when they donated. The minimum age for donation is 18-25 depending on the transplant center.
If you are considering donating a kidney in the future, but are concerned your age may be an issue, the National Kidney Registry Voucher Program lets potential donors donate a kidney now and give vouchers to up to five family members. If any of the voucher holders need a kidney in the future, they can activate their voucher to receive priority consideration for a well-matched kidney from a living donor through the NKR. Only one voucher can be redeemed per voucher donor.
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What Are The Advantages Of Living Donation Over Deceased Donation
Kidney transplants performed from living donors may have several advantages compared to transplants performed from deceased donors:
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What Processes Do You Have To Go Through To Be A Living Kidney Donor
The decision to donate a kidney is just the first step on a journey that may eventually lead to a kidney transplant operation.
Everyone who wants to donate is asked to go through a number of tests and examinations. These checks are designed to ensure that you are healthy enough to give a kidney, that your kidneys are currently working well and that you are physically and emotionally prepared for the donation. Your safety and well-being is always the priority for the medical teams and you should be aware from the beginning that there may be a number of reasons why you might not be suitable to donate. The tests and checks can take several months , which include medical, surgical and psychological assessments.
In England, Wales and Northern Ireland, no minimum age limit is specified under the Human Tissue Act 2004, but most donors will be over the age of 18 years. In Scotland, the law specifies that the donor has to be over 16. There is no upper age limit, and there have been donors in their 70s and 80s.
Throughout the process, anonymity and confidentiality are necessary, and most altruistic donors never meet the person who receives their donated kidney. It is, however, possible for both parties to contact each other after the transplantation, but only if both parties are willing.
Tests and examinations before the operation
General physical health
Psychological health
Urine tests
Blood tests
Glucose tolerance test
Blood pressure monitoring
Kidney tests
ECG
Chest X-ray
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