Living Kidney Donor Program
While most transplant kidneys come from people who have died or whose blood-relatives gave permission for organ donation, there simply are not enough organs to go around. Each year more patients nationwide are added to the kidney transplant waiting list, extending wait times for kidneys. Through the Living Donor Program at Loma Linda University Medical Center, you can help save a patient’s life. Understanding kidney donation will help you make the best decision.
Kidney transplantation is an acceptable and highly successful treatment option for people whose kidneys have stopped working. Compared to kidneys coming from a deceased donor, living donor kidney transplants have transplant recipient advantages which include:
- Less waiting time
- Lower incidence of rejection
- Lower doses of necessary medication
- Greater long-term success rates
Donating a kidney means giving a tremendous gift to another person. It’s a decision that only you, the potential donor, can make. At the Transplantation Institute, all living donor nephrectomies (kidney removal surgeries) are safe and performed laparoscopically (hand-assisted). With our Kidney Transplant Team’s high level of experience, living kidney donors experience smaller incisions, less pain, shorter hospital stays and faster recovery.
To donate a kidney, you do not need to be related to the transplant patient. However, a blood-related family member is more likely to be a good match. Whether a blood-relative, spouse, in-law or close friend, all living donor transplants tend to have successful outcomes.
Potential living donors are carefully screened to evaluate if they are immunologically compatible. Living donors must also be in excellent health, well informed about transplantation and able to give informed consent. Basic criteria for becoming a donor include:
- Between the age of 18 and 65 years old
- Good general health (no history of diabetes, high blood pressure or hepatitis)
- No history of kidney disease
- No major weight problems
- Willing and interested in donating a kidney
Blood typing --There are four different blood types. They are A, B, AB, and 0. Every person has one of these blood types. The donor's blood type does not have to be the same as the recipient's blood type, but it has to be compatible. It does not matter if the donor's blood type is Rh (+) or (-).
Process & Procedure
The living donor transplant coordinator evaluates the potential donor’s medical history. Both the recipient and potential donor undergo three initial blood tests to check for compatibility:
- Blood type – Checks to see if recipient and donor have the same blood type or compatible blood type
- Crossmatch – Measures the reaction of the recipient’s blood to donor’s blood
- Tissue-typing – Looks for similarities in the donor and recipient’s tissues
Once it’s determined that the potential donor and recipient are compatible, additional testing is done on the donor to safeguard the donor's health and to ensure that the donor has adequate kidney function. Typically, donor testing involves many blood tests (including tests for viral diseases), urine tests, a chest x-ray, an electrocardiogram (EKG) and a CAT scan. The donor evaluation also includes appointments with individual Kidney Transplant Team members such as a social worker, nephrologist and surgeon.
The donor evaluation time period varies with each person and depends on the potential donor's availability to schedule appointments. In general, the evaluation period takes approximately six weeks to three months to complete. Once the evaluation is complete, a date for the transplant surgery is set.
One to two weeks prior to surgery, a final physical examination and several routine tests are performed to ensure that both donor and recipient are healthy and remain crossmatch compatible. On the day of the scheduled transplant surgery, the donor and recipient are admitted to the hospital at the same time.
The Transplantation Institute’s Kidney Transplant Team will perform a hand-assisted laparoscopic donor nephrectomy, a major operation to safely remove the kidney. The surgery takes approximately four hours and is performed under general anesthesia. The surgeon inserts a tiny camera and slim surgical instruments through four small holes into the donor's abdomen. With these instruments the surgeon detaches the kidney, arteries, veins and ureter. The kidney is removed through a small incision (approximately 2 1/2 inches). This cutting-edge technique reduces recovery time and pain for the donor. The recipient’s transplant operation will immediately follow the donor nephrectomy and may take place in an adjoining operating room.
After surgery, the donor is taken to the recovery room and then the transplant unit. Pain that the donor may experience is controlled with intravenous pain medication. On average, the donor will remain in the hospital for three days.
Everyone recovers differently. Most donors heal quickly and have an uncomplicated course of recovery, while others may experience some discomfort around the incision site and a general feeling of tiredness following surgery. This is the body's natural reaction to surgery, and it will improve in time.
Following hospital discharge, it’s important donors rest as needed and not over-exert themselves. Avoid heavy lifting (anything over 15 pounds) or extreme physical exertion for 12 weeks. No driving for two weeks after surgery. Most donors can return to work or school approximately four to six weeks post surgery. Donors can also resume sexual relations approximately three to four weeks after being discharged from the hospital.
The transplant recipient’s insurance and/or Medicare will pay for all of the living donor's medical expenses related to the kidney donation including evaluation, surgery, hospitalization and post-operative care. In the event that the evaluation uncovers medical conditions requiring treatment, the donor becomes the responsible party.
Generally, insurers do not pay for travel, meals or lodging expenses incurred pre- or post- surgery. Loss of wages or salary during the donor’s recovery process in the hospital or at home is not reimbursed. If a California resident, state disability insurance and / or sick or vacation time from work are means of financial support during this time. In certain circumstances donors may meet criteria to obtain a grant to provide financial aid for the expenses they would incur through the donation process through funding from National Living Donor Assistance Center (NLADC).
At the Transplantation Institute, the financial coordinator and social worker are available to discuss financial concerns. Should you receive any bills related to the donation evaluation from the hospital, labs or physicians, please forward them immediately to the financial coordinator.
National Kidney Registry
The National Kidney Registry is a non-profit organization dedicated to saving and improving the lives of patients facing kidney failure by increasing the number of living donor transplants. This program offers paired exchange (“kidney swap”) and donor chains to those who have an incompatible donor. Altruistic donors (“good samaritan donors”) can also donate through this organization. To learn more about this chain donation process, visit the National Kidney Registry online.