Living Donation

Living donor transplants have a higher success rate and generally start functioning immediately after transplant. They have a quicker recovery time & have improved long-term outcomes. Living donor surgeries can be scheduled, allowing preparation time for both the donor and the recipient.

A living donor transplant decreases the time a person has to wait to receive a transplant as well as increases the number of organs available to those on the deceased donor transplant waiting list.

The decision to donate can vary from person to person. Some people make the decision instantly while others may need time to think and talk to family or friends before deciding to donate.

It is normal for a person to feel afraid to donate or guilty about not wanting to be a donor.

People should not feel pressured to donate. Any person considering donation should speak to the living donor team and their independent living donor advocate at the transplant center for answers to their questions or to discuss their concerns.

The only ‘right’ decision is the one that is comfortable for the donor.

Living donors must be 18 years of age or older and be able to give consent. They need to be in good physical and mental health. Some medical conditions such as kidney disease, liver disease, diabetes, uncontrolled high blood pressure, obesity, cancer or an uncontrolled psychiatric condition could prevent someone from being a living donor. The transplant center team can provide more information about their criteria for living donors. Potential donors need to share all of their physical and mental health information with the transplant center team. It is also very important that the decision to donate is completely voluntary and free of pressure.

Kidney – No, a living kidney donor does not need to be the same blood type as their recipient. Living kidney donation provides the donor and recipient pairs with alternative options. The transplant team will decide which option is best for both the donor and the recipient.

Liver – Yes, a liver donor needs to have the same blood type as the recipient.

Blood type O is the universal donor. This means they can donate an organ to all blood types.

• Blood type AB is the universal recipient. This means they can receive an organ from all blood types.
• The +/- in a blood type does not matter in transplant

At this time, paired exchange programs are available for kidney donors and their recipients. In a paired exchange, a donor will donate their kidney to another recipient in exchange for a kidney that matches their recipient. Kidney paired donation (KPD) is a transplant option for recipients who have a living donor who is medically able, but cannot donate a kidney to them because they are poorly matched.

Kidney donation – The surgical procedure to remove a kidney is called a laparoscopic nephrectomy. During this procedure, the surgeon will make two small incisions for their instruments and a slightly larger incision (~3 inches) to remove the kidney on the abdomen. The surgery is approximately 2-3 hours long. There are several benefits to having a laparoscopic nephrectomy. Some of these benefits include a decrease in discomfort after surgery requiring less pain medication, a shorter length of stay in the hospital and a faster recovery period.

Liver donation – The surgical procedure to remove a portion of the liver is called a partial hepatectomy. An incision is made across the abdomen to locate the appropriate portion of the liver being removed. The surgery is approximately 6-8 hours long.

All donors complete a thorough medical evaluation prior to donation which includes meeting with the transplant multidisciplinary team as well as testing. The multidisciplinary team includes a Nephrologist, Surgeon, Pharmacist, Dietician, Social Worker, Transplant Psychologist, Coordinator and an Independent Living Donor Advocate.

Kidney donation – Some of the testing completed for a kidney donor may include an EKG, a CT scan, a chest x-ray, nuclear medicine GFR study and bloodwork

Liver donation – Some of the testing completed for a liver donor may include an EKG, a CT scan, MRI, chest x-ray and bloodwork.

All costs related to the medical evaluation are covered by the recipient’s health insurance.

While there are risks to all medical procedures the risks of a person having lifelong complications after donation are minimal. A transplant center will only move forward with a donor if they truly feel donation is in their best interest.

Kidney donation – A kidney donor’s overall long-term survival is similar to those who have not donated a kidney. Their risk of developing end-stage renal disease (ESRD) is significantly lower than the general unscreened public. There are no dietary or lifestyle changes a donor needs to make after donation except for the use of NSAID’s or Non-Steroidal Anti-inflammatory Drugs, as these drugs can be harmful to the kidneys. Common drugs in this class include Ibuprofen, Alieve and Naproxen.

Liver donation – A liver donors overall long-term survival is similar to those who have not donated a liver. A liver donor will need to abstain from alcohol for one year after donation.

All donors are highly encouraged to continue a healthy lifestyle and see their primary care providers on an annual basis to ensure continued health.

Kidney donation – The average recovery time for a kidney donor is 4-6 weeks. A donor will stay in the hospital for 2-3 days. The remaining recovery is done at home. There is a 10 pound lifting restriction after surgery for 6 weeks. This lifting restriction is to help prevent a hernia from developing.

Liver donation – The average recovery time for a liver donor is 8 weeks. A donor will stay in the hospital for about 7 days. They will be in the ICU for 2 of these days to closely monitor their status and pain control. Pain control is an important part of the recovery process especially the week after surgery.

Liver donors will have a large abdominal incision with drains placed as well as a nasogastric tube during their hospital stay. There is a 10 pound lifting restriction after surgery for 8 weeks. Liver donors cannot drive while on narcotics so most donors need someone to take them to their first follow up appointments after surgery.

All transplant centers are required to follow their donors for two years after donation. Donors are seen 7-10 days after surgery as well as at six months, one year and two years after donation. Blood and urine samples are collected at each appointment. Once the two year reporting period is complete, donors are encouraged to follow with their primary care providers and have blood and urine samples tested annually.

Yes, women of childbearing age can get pregnant and have children after kidney or liver donation. The surgical procedures to remove a kidney or liver do not affect the reproductive organs.

All costs related to donation such as the evaluation, testing and surgery are covered by the recipient’s insurance. Personal expenses such as travel, housing, child-care costs and lost wages however are not covered by the recipient’s insurance. Resources such as the National Living Donor Assistance Center (NLDAC) may be available to help cover some of these expenses. During the evaluation process a Social Worker will meet with the donor to discuss all financial aid programs available to them. Employers may provide FMLA to their employees per the Wisconsin Assembly Bill 752.

Living donors generally rate their overall experience as positive and say in retrospect, they would have still made the decision to donate. Most published reports indicate that donors have an improved sense of well-being, a boost in self-esteem and report an excellent quality of life after donation.