Why is a kidney transplant from a living donor better than one from a deceased donor?
A. Kidney donation from a living donor provides some major benefits for individuals with renal failure. Data shows that a living donor kidney not only functions better, but it lasts longer. Overall, benefits of a living donor transplant include:
- Better long term transplant kidney survival
- Faster access to transplantation
- A reduced risk of rejection.
What does it take to be a kidney donor?
A living kidney donor is usually between ages 18 to 65 and in excellent health. Donors over age 65 are considered on a case by case basis.
What might rule out someone as a kidney donor?
History of heart disease, chronic lung or liver disease, kidney disease, hypertension, diabetes, cancer or untreated psychiatric disease is usually a contraindication to donating (i.e. the donor candidate is “ruled out”). Smoking, obesity and other health issues are considered on an individual basis.
What does kidney transplant surgery involve?
The surgical procedure to remove a kidney from the donor is called a donor nephrectomy and takes approximately 2-3 hours. Surgeons primarily use a minimally invasive technique, using 3 small incisions to insert instruments and a slightly larger incision (~8 cm in length) to remove the donor’s kidney. Typically donors spend 2-3 days in recovery before being discharged from the hospital.
What risks are there to kidney donors?
Once a living donor candidate has been completely evaluated and cleared, the chance of the donation affecting his/her lifespan or lifestyle is extremely low. With any surgery and anesthesia, however, there are risks. Nationally, the risk of having a life-threatening problem with donating a kidney is 1 in 3,000. The risk of minor complications such as a minor wound infection is about 2-4%.
What is recovery like?
Because the kidney donor operation is a major surgical procedure, donors find they have less energy and need about 4-6 weeks to return to their full pre-surgical activity level. For donors who worked prior to surgery, disability coverage allows 6 weeks off for recovery; however, some donors return to work before this time.
Who pays for a donor’s medical costs?
All expenses for the medical work-up and transplant surgery are covered by the recipient’s health insurance. In considering donation, candidates need to consider additional expenses such as:
- Parking, lodging, gas, food and other incidentals
- Lost wages if sick time or short-term disability from work is not available.
Financial coordinators and social workers can discuss your specific circumstances in more detail prior to the decision for surgery.
What is the long-term outcome for kidney donors?
The New England Journal of Medicine and Journal of the American Medical Association published long-term studies in 2009 and 2010 analyzing outcomes of kidney donors. One study followed 80,000 live kidney donors dating back to 1994, while the other studied 3,698 individuals who donated a kidney between 1963 and 2007. Results showed:
Donor survival was similar to that of the general control population (people who had not had a kidney removed) matched for age, sex, and race or ethnic group.
The rate of end-stage renal disease (ESRD) was significantly lower in the group of patients who donated a kidney than the rate in the general population (180 versus 268 per million per year).
After donating one kidney (removing 50 percent of the functioning kidney mass), the remaining normal kidney compensates and the overall kidney function (measured in GFR, or glomerular filtration rate) increases to approximately 70 percent of baseline at about two weeks and approximately 75 to 85 percent of baseline at long-term follow-up.
Can a female donor have children after donating a kidney?
Women of childbearing age can have children after kidney donation because the donor surgery does not affect their reproductive organs.
Does a donor need follow-up medical care after donation?
Each transplant program has their own criteria for follow up usually two to three weeks following a donor’s discharge. Six, 12 and 24 months following donation, donors are asked to complete lab work and a questionnaire. Encouraged to see their PCP.
Adapted from Sutter Health CPMC San Francisco, California
For more information:
University Transplant Program (210) 567-5577
Methodist Transplant Program (210) 526-0872