The Piedmont Transplant team understands you and your family have questions and concerns. Here are some answers to frequently asked questions about kidney transplant surgery. Contact your coordinator for more information.
What is living donation?
Living donation is the voluntary act of a living person donating an organ to another person for transplantation.
Who can be a living donor?
Anyone whose blood and tissue type is compatible with the recipient's, is determined healthy enough to safely undergo surgery, and is willing to have the procedure. Specific requirements vary slightly from center to center. Requirements at the Piedmont Transplant Institute can be found here.
Can a person live with one kidney?
Yes. A healthy person can live a long, healthy life with the other kidney. The remaining kidney takes over the work for both kidneys.
How are living donors selected?
Criteria include age, medical and mental health, family history of hereditary diseases, and blood and tissue compatibility. Generally, a donor must be at least 18 years old. People who wish to become living donors undergo a medical and psychological evaluation. Everything that occurs during the medical and psychological evaluations is kept confidential. The selection process is very rigorous; therefore the recipient should have more than one potential donor on hand. The more potential donors a recipient has, the greater the likelihood that one of those potential donors will be able to actually donate an organ. Learn more about donating a kidney.
Are there risks for a living donor?
A donor faces the same risks as with any other major surgery - including bleeding, infection, blood clots, complications from anesthesia and, in some very rare cases, death. Nationally, the risk of death from the donor surgery is 1 in 3200, roughly the same as dying in a car accident. Although a potential donor receives a free medical evaluation, the medical team could unexpectedly discover an undiagnosed chronic condition like diabetes or cancer. After the operation, some donors experience a slight increase in blood pressure. However, research shows that kidney donation does not damage the donor's long-term health. Female donors can still go on to have healthy babies.
Are donors at risk for developing kidney disease?
Research shows that properly selected donors do not seem to be at greater risk than the rest of the population for developing kidney disease; however, there are no guarantees that a donor will not develop kidney failure due to an injury or undiagnosed medical condition. The risk of a donor developing end stage kidney disease requiring transplantation is 0.01-0.04%; the same as the general population. Donors are encouraged to have annual physical exams so that their blood pressure and kidney function can be monitored regularly.
What are the expenses involved with living donation?
In most cases, the recipient's insurance should cover all medical expenses associated with donation, including the medical evaluation, hospitalization, surgery costs and post-operative care. However, insurance will not cover the donor's travel and lodging expenses, childcare expenses and lost wages for time away from work. (Employees of Piedmont Hospital and Piedmont Fayette Hospital can take advantage of a Living Donor Leave benefit, which provides up to 30 days' paid leave for organ donors and up to seven days' paid leave for bone marrow donors.) Piedmont continues to work earnestly with insurance companies to support coverage for living donors. Out of State donors may be eligible for certain travel expenses from the National Living Donor Assistance program. Each donor's situation is reviewed on a case by case basis by a social worker/financial coordinator.
Most states have enacted legislation to provide limited benefits for potential organ donors. You can review the specific laws in your state of residence here.
What is the expected recovery time for a donor?
Recovery time will depend on the type of surgery and the individual patient. The standard approach at our institution is a minimally invasive, laparoscopic surgery with or without robotic assistance. Most patients are expected to stay in the hospital 1-3 days. Recovery time, at home, can be up to 6 weeks.
Some donors may require an "open" procedure to remove their kidney. Because of the more invasive nature of this technique, donors can expect to spend more time in the hospital recovering (4-5 days).
How is compatibility determined?
Two tests are performed to determine if a kidney transplant is possible. ABO compatibility determines whether or not the donor's blood type is suitable for the recipient. In addition to ABO compatibility, the immunology laboratory will conduct HLA (human leukocyte antigen) typing to establish antigen identification and a crossmatch to determine antibody compatibility. HLAs are proteins on white blood cells. A child inherits three antigens from each parent. Hundreds of different antigen molecules have been identified.
What is a crossmatch?
A crossmatch mixes the recipient's serum with the donor's white blood cells to determine if the donor's antibodies and the recipient's antibodies are compatible. An antibody is a protein made by the body's immune system in response to a foreign substance. People can develop antibodies from a prior pregnancy, blood transfusion or previous organ transplant.
I am interested in becoming a donor. What should I do?
First, you should consult the patient's transplant coordinator to have a simple blood test for compatibility with the recipient. You would then undergo a two-day medical and psychological evaluation by the transplant team to determine if you are a good candidate to donate a kidney. If you are approved as a compatible donor, the transplant coordinator will schedule the surgeries at a convenient time for both you and the recipient.