Answering Your Questions About Living Donation

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Donating a kidney to a loved one who has kidney failure can be a very positive experience for the donor. A Florida business executive donated a kidney to his identical twin, a surfing champ whose kidney failure came as a real shock to his family. This man reported that donating a kidney to his brother was "an absolutely wonderful feeling." A California newlywed donated a kidney to her new husband who lost his first kidney transplant, which he had received from his brother 13 years earlier when his own kidneys failed. This young woman described her donation as "a very special bond we'll share for the rest of our lives." These are just a couple of examples; many other 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 living person donates an organ or part of an organ to be transplanted into a loved one in need. The living 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.

What organs can come from living donors?

The organ most commonly given by a living donor is the kidney. People usually have two kidneys, and one is all that is needed to live a normal life. Parts of other organs including the lung, liver and pancreas have also been transplanted from living donors.

What are the advantages of living donation?

Living kidney transplantation has a number of advantages compared with kidney transplantation from a person who has died (cadaver donor). First, since the living kidney donor is usually a close relative of the person getting the transplant, there is a better match and less chance of rejection. Second, the transplant can be scheduled ahead of time, something that cannot be done when the patient is on a waiting list for a cadaveric kidney. Third, kidneys that come from living donors begin to function immediately after the transplant. while cadaveric kidneys may take several days or weeks before they begin to function normally.

What determines who can become a living donor?

Acceptible living donors are usually between 18 and 60 years of age and are often close relatives of the intended recipient. The prospective donor must have a compatible blood and tissue type as determined by tests of the donor and recipient. The donor is carefully evaluated by physical examination, tests to assure normal kidney fundtion and studies to show the presence of two normal kidneys. Absence of hereditary diseases affecting close family donors should also be addressed. Psychological evaluation may also be recommended. The decision about whether to accept the donor is then made by the health care team at the transplant center.

Can someone who is not a close relative be a living donor?

Some transplant centers are undertaking transplantation from living unrelated donors. A living unrelated donor is someone who has emotional ties to the recipient, such as a close friend. Living unrelated kidney transplantation has been quite successful in most cases.

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 working lives within 2 to 6 weeks.

Suppose someone decides against being a living donor?

A decision to become a living donor should be voluntary and 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, individuals who have kidney failure have the right to decide that they do not want a transplant. The patient must live with the disease, and he or she alone has the right to decide what is to be done. That decision, as well as the donor's, must be respected.

What does the operation involve?

Once all the tests are completed, the donor and transplant operations are scheduled. For surgery, the donor and recipient are usually in adjacent operating rooms. The kidney is removed in a careful way and transplanted into the recipient. The hospital stay for the donor is usually about a week after the operation. The donor may visit the doctor's office or clinic to make sure the wound is healing well and that recovery is proceeding as expected. In general, no further treatments or office visits are needed.

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 Medicare or the recipient's insurance. There is no cost to the donor. However, the donor usually is not paid for time off from work. 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.

What if I have more questions?

If you have additional questions, you should speak to a transplant physician or to the transplant coordinator at your nearest transplant center. You can also get more information by contacting your local National Kidney Foundation office.

What is the National Kidney Foundation and how does it help?

More than 20 million Americans have some form of kidney or urologic disease. Millions more are at risk. The National Kidney Foundation, Inc., a major voluntary health organization, is working to find the answers through prevention, treatment and cure. Through its 52 Affiliates nationwide, the Foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded entirely by public donations.