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Frequently Asked Questions About Kidney Donation

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November 13, 2020

Tens of thousands of people in the United States are waiting for new kidneys – a much greater need than kidneys from deceased donors alone can meet. Living kidney donation helps make more kidneys available to more people in need.

Kidneys filter waste and excess fluids from the blood, eliminating them from the body in urine.  Chronic kidney disease or failure is the gradual loss of kidney function, causing a dangerous amount of waste build-up in the body. Those who have kidney disease are often placed on the kidney transplant waiting list to become organ recipients.

A new kidney can extend a recipient’s life by at least 15 years. More than 101,000 Americans are currently on the transplant list, but only 17,000 receive a kidney annually. Sadly, 12 people die each day while waiting for a kidney. By donating a kidney, you can save a life. Read on and learn more in our FAQ about kidney donations.

Common kidney donor questions

Becoming a kidney donor is an important decision that requires careful thought. The process may seem scary, but it is a safe procedure performed by experienced surgeons. By understanding what to expect, more people may become kidney donors.

  • Kidneys can be transplanted from a healthy living donor or from deceased individuals who have registered as organ donors. Those awaiting a kidney are placed on an organ waiting list. Available kidneys must match the recipient. The list also considers medical needs, length of time waiting and other factors.

  • Yes, a living person can donate a kidney to either someone they know or a stranger. Kidneys are the most donated organs from a living donor. Living donors can continue to enjoy active, healthy lives with a single kidney and have tremendous opportunity to give an invaluable gift to someone in need.

  • Yes, you absolutely can donate your kidney and live. You have 2 kidneys, and your body can function very well with just 1. The remaining kidney will grow slightly and do as much work as 2 did. In fact, it is the preferred method of transplant. People who receive kidneys from living donors are healthier and live longer than those who receive kidneys from deceased donors.

  • A living donor kidney transplant involves a live person donating their kidney to a person in need. There are several different types of living donation:

    • Living related donation: The donor directs their organ to a family member in need. This accounts for 75% of all kidney donations.
    • Living unrelated donation: The donor directs their organ to a friend, co-worker or spouse, which accounts for about 24% of all living kidney donations.
    • Nondirected living kidney donor: A kidney from a stranger makes up only 1% of all live kidney donations each year. About 1,700 people donate a kidney to strangers in the name of altruism each year.
    • Paired exchange (or larger): Sometimes, organ donations are set up for those who wish to donate to a family member or known recipient but are not a match for the intended recipient. Instead, they give their organ to someone else in need, and that person’s intended donor reciprocates.
  • Reasons that someone may become a kidney donor include:

    • Supporting a family member with end-stage kidney disease
    • Donating to a stranger on the organ transplant list
    • Joining a registry to become an organ donor after death
    • Pairing up with another family as part of an organ exchange so that your loved one will receive an organ
  • Yes. This is more common than receiving a kidney from a stranger and can be preferred. When you are genetically related, you’re more likely to be a compatible kidney donor. If you are not a compatible match with your chosen recipient, you may consider orchestrating a paired exchange. Your recipient’s healthcare team can help you find others to pair with.

  • Becoming a living kidney donor requires a thorough health exam and being tested to check for potential compatibility between you and your recipient. If you’re considering becoming a donor, contact a physician in your area. Talk with your intended recipient’s care team if you wish to donate to someone you know.

  • The University of Kansas Health System has an experienced kidney team that manages kidney transplant care before, during and after surgery. The specialized kidney doctors on staff, including nephrologists and transplant surgeons, provide expert care for patients with kidney disease and pancreas disorders. The team is nationally recognized and offers comprehensive and compassionate treatment for you and your loved ones.

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Testing for a match for kidney donation

Making sure that the kidney will be compatible with the recipient’s body is essential. There are many steps for screening between the donor and recipient to ensure a successful transplant. An experienced transplant care team will assist you and your recipient through this process.

Don’t let concerns about incompatibility stop these conversations. You may not be compatible with your intended recipient, but you may be a fit for a paired match through which you can donate to a stranger, and that stranger’s intended donor’s kidney would be a match for your intended recipient. Your healthcare team will help you explore this.

  • To be a donor, you must be at least 18 years old, in overall good health, and with a body mass index (BMI) under 30. The following criteria will exclude you from donation:

    • Uncontrolled, elevated blood pressure
    • History of pulmonary embolism or blood clots
    • Bleeding disorders
    • Uncontrolled psychiatric illness
    • Morbid obesity (BMI 35 or higher)
    • Uncontrolled cardiovascular disease
    • Chronic lung disease
    • History of melanoma (a type of skin cancer)
    • History of metastatic cancer (cancer that spread to other organs)
    • Bilateral or recurrent kidney stones
    • Chronic kidney disease
    • Protein in the urine or blood
    • HIV infection
  • Transplant teams will explore several criteria in determining effective kidney matches:

    • Age
    • Overall health screening
    • Urine and blood laboratory tests
    • Organ compatibility (blood and tissue type)
    • Psychiatric evaluation
  • The bloodwork to be a living donor includes:

    • Blood type
    • Crossmatch
    • Tissue (HLA) type
    • Other blood work
  • Yes, the following blood types are compatible. The Rh factor, positive or negative, does not influence the testing.

    • A can donate to A and AB recipients
    • B can donate to B and AB recipients
    • AB can donate to AB recipients
    • O can donate to O, A, B and AB recipients

    Even if your blood type does not match that of your intended recipient, continue conversations with your healthcare team. You may be a match for an unknown recipient whose intended donor could be a match for your intended recipient. A paired exchange may be possible.

  • Once you’ve completed the health screening and the blood type compatibility labs, there are still other tests to perform. The tests include:

    • Crossmatch: This laboratory test will be performed multiple times, including immediately before transplant surgery. Your cells will be mixed with the recipient’s serum to check if antibodies bind to the donor cells. If the crossmatch is positive, the transplant cannot take place because the kidney will be rejected.
    • Tissue (HLA) type: The better the match, the more successful the transplant. Parents and children have the best chance of matching, then siblings. Unrelated donors are less likely to match. The ideal match is for the recipient to have all 12 markers fit the donor without any mismatch. If you have a common HLA type, unrelated donors may still match.
    • Other blood work: Tests for your kidney, liver and blood counts to ensure your health – both to have successful surgery and to remain healthy for years to come following the surgery.
  • Living kidney donor testing evaluation can take about 3-6 months.

Expectations for kidney donors

  • You need to be in good physical and mental health to donate your kidney. Make healthy habit changes like adding exercise, eating nutritiously and engaging in regular meditation. While your bloodwork may be a match, there will also be psychological evaluations to ensure you understand the procedure and any long-term risks.

  • There are some risks when you donate a kidney.

    • Infection
    • Bleeding
    • Intestinal obstruction
    • Fatigue
    • Hernia
    • Blood clots
    • Pneumonia
    • Nerve injury
    • Increased risk for kidney disease
    • Elevated blood pressure later in life
    • Anxiety or depression

    Most living kidney donors experience no long-term effects and lead perfectly healthy lives with a single kidney.

  • Yes. Your remaining kidney will take over and provide the proper function to remove waste from the body.

  • No, kidney donors do not need any medications related explicitly to kidney donation in the long-term. There are some medications you will have to avoid like ibuprofen and naproxen sodium because they negatively affect your kidney.

  • Studies have shown that kidney donors live just as long as non-donors.

  • No. It is against the law to get paid to be a kidney donor. You should not incur any expenses for your medical care in the course of being a kidney donor, either, including the testing before the transplant, the surgery itself and the aftercare. However, you may experience financial loss due to missing work after the transplant or medical care. Some employers offer paid leave for organ donation, but many do not. Talk to your human resources department to learn about any potential support.

  • No. Your kidney will not grow back.

Kidney donor eligibility

To be a kidney donor, you must be an adult over 18 years old in overall good health and without a significant history of psychiatric conditions. Many forms of cardiovascular disease also exclude you from being a living donor.

  • No, someone with hypertension (130/90 or higher) and 1 of the following conditions cannot be a living donor:

    • Under 50 years old
    • End-organ damage
    • Not Caucasian
    • 3 or more anti-hypertensive medications
  • No, if you have had cancer recently or it resolved but recurred, you cannot donate your kidney. However, there are some circumstances in which you may be able to be a living donor. If cancer occurred a long time ago, it might be possible. Talk to the kidney care team to see what the options may be.

  • No, the United Network for Organ Sharing excludes those with diabetes from being a donor.

  • It depends on any other factors. While high cholesterol can be a concerning risk factor for kidney donation, it is not an absolute exclusion. Speaking to a transplant coordinator regarding your concerns is an excellent option.

  • People with multiple sclerosis (MS) may donate organs, but this varies from state to state and even by the facility. With proper informed consent about the risks, people with MS can reasonably donate their kidneys.

  • A horseshoe kidney is the most common urinary congenital anomaly. Donors with horseshoe kidneys are infrequent but do occur. A donation from someone with a horseshoe kidney is typically only considered in situations where the horseshoe kidney’s anatomy is suitable, there is a low operative risk to the donor and the donor is the best option for the recipient.

  • It depends on the severity and frequency of your kidney stones. If you had stones once or on 1 side, it likely wouldn’t interfere. However, if you have recurrent kidney stones, that could interfere with the body’s ability to filter waste with 1 kidney. Talk to your nephrologist regarding kidney transplants with stones.

  • Being a smoker does not necessarily exclude you from being a kidney donor. However, it may increase donor complications and decrease recipient survival when compared with a nonsmoker. Smoking is considered a risk to donors and recipients alike. If you smoke in the posttransplant period, it may affect healing time and renal function. However, quitting smoking can improve outcomes.

  • It depends. If you drink alcohol in moderation, talk to your kidney team. You likely can proceed with the donation. If you have issues with drug or alcohol abuse, you may not be able to donate your kidney because of how alcohol affects it. The kidneys filter alcohol, which can dehydrate you, affect the ability to filter blood and interfere with normal renal function. Too much alcohol increases blood pressure and worsens kidney disease.

  • Yes, but as with any exposure to needles with blood and bodily fluids, there is always a small risk of transmitting a virus like HIV or hepatitis. Thus, it is vital to use a reputable tattoo parlor that meets all regulations. There may be a waiting period for up to 6 months following a new tattoo to ensure no risk for disease.

Kidney transplant surgery

  • Kidney transplant surgery takes about 2-3 hours for the donor. Kidney transplant surgeries are usually done laparoscopically. A laparoscope is a thin, lighted tube inserted through small incisions on your body to view inside. The surgeon removes a kidney through an incision just large enough for the kidney to fit through. The laparoscopic surgery is much shorter than traditional open surgery.

  • This surgery also takes about 3 hours. The recipient’s kidneys typically stay in place, and the surgeon connects the donor kidney to the renal blood flow. The new kidney is also attached to the ureter, the tube that carries urine away from the kidney. Once the kidney is producing urine, the surgeon will close the incisions.

Kidney donation recovery

To donate a kidney, you have to have excellent overall health. While this will narrow the number of people who can be donors, it also ensures that they can live long, healthy lives after the surgery.

  • The recovery time for a kidney donor depends on the type of surgery for kidney removal.

    • Laparoscopic kidney removal is most common, minimally invasive and allows discharge from the hospital within a couple of days. The donor can usually return to work in 1-6 weeks. If you sit at a desk, for example, you can likely resume work sooner than someone who is more active and spends more time on their feet.
    • Surgery without a laparoscope may have a longer recovery time and may require a longer hospital stay and more time off work.
  • The recovery time for a kidney recipient is longer than for a donor because they take anti-rejection medications like steroids. They will typically stay in the hospital for a week with careful monitoring. About 2 weeks after the surgery, recipients should start feeling much better. However, the total length of time to fully recover from the surgery is 6 months.

  • Yes, kidney donors can eventually drink 1-2 alcoholic drinks but should abstain in the weeks following the transplant. Women and those over 65 should stick to 1 alcoholic beverage per day at most, while men should have no more than 2 drinks in a day. One drink is 1 12-ounce beer, 1 5-ounce glass of wine or 1 1.5-ounce liquor shot. More than 2 drinks a day puts donors and recipients alike at risk for kidney and liver disease. While kidney donors should avoid excessive intake, it is safe to consume alcohol in moderation.

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