Living Organ Donations

In the Lankenau Kidney Transplant Program, living donors are more than just a kidney; more than just another surgery to perform. Living donors save lives. Without them, there is no surgery and much less hope. At Lankenau we provide living donors with the same level of personal care and professional expertise given to the kidney recipient.

Who Can be a Living Donor?

There are two designations for living donors: Living-Related and Living-Unrelated.

• Living-Related Donors: In most cases, a living donor will be a member of the patient’s own family – a brother, sister, parent, children or other blood relative who is 18 years or older.
• Living-Unrelated Donors: Someone who is not directly related to the patient (a husband, wife or friend, for example) may be a possible donor.

Making the Decision to Donate a Kidney

If you are considering becoming a kidney donor, it is important that you have a full understanding of all aspects of kidney donation and transplantation. Transplant Team counselors will meet with you to help you decide what is best for you, for your family and for the recipient of your kidney.

A number of resources are also available to provide education and support to possible donors. These are listed in the Education and Support section of this site.

Donation Process

Assuring the health of the donor and the compatibility of the donor kidney is one of the first critical steps in the donation process. A donor must be in good health, and must be tested to see that he or she has the an acceptable blood group and tissue type. Doctors must also determine if the donor has any potentially problematic health conditions.

The prospective donor will also be counseled regarding long-term health considerations, financial and insurance matters and other issues that could affect an individual’s decision to serve as a kidney donor.

All information shared during this process will be kept strictly confidential between the patient and the Transplant Team. Information will not be shared with the recipient or the recipient’s physician unless authorized by the donor.

At any time in the process, the donor can make the decision not to go forward with the donation.

Testing Procedures

Potential donors will have blood, urine and radiology tests to check for health problems, and to determine compatibility with the recipient.

A complete physical exam will be done, including an EKG to assess heart function, and a chest x-ray to check the lungs for possible abnormalities. X-rays will also be taken to identify the structure of the kidney, veins, arteries, ureter and other parts of the anatomy. Female donors may be asked to undergo a gynecological exam and mammography.

Kidney function tests will be performed to evaluate the condition of your kidneys. Additionally, your medical history will be reviewed for possible past illnesses or surgeries that could affect your ability to donate. A psychological evaluation will also be required.

Health Risks & Other Considerations

If you are considering donating a kidney, you need to be aware of the potential medical risks. But, you should also know that you can live a normal, healthy life with one kidney.

Urology professionals have long known that diseased kidneys can be removed from healthy individuals with no long-term consequences to those individuals. In the United States, surgeons began performing living donor kidney transplantation in 1954. Over the past nearly 50 years, the transplant community has had ample opportunity to observe individuals who have given up a kidney to a loved one. Individual patients have been followed for more than 20 years after donation, again, proving no serious long-term consequences.

While there are some potential risks, it is believed that kidney donation is not only safe, but is the preferred choice of kidney transplantation for potential kidney transplant recipients. This is obvious in the fact that all kidney transplant centers in the United States feel living donor kidney transplantation is ethically and morally justified.

In 2002, more than 40 percent of kidney transplants done in the United States were from living donors.

Medical Considerations

There are some medical consequences that have been observed after kidney donation. To understand these potential problems, it’s important to understand what happens to kidney function after the removal of one kidney.

• Kidney Function: Individuals who go from two functioning kidneys to one functioning kidney lose 50% of their kidney function immediately at the time of surgery. In a healthy individual the remaining kidney will eventually hypertrophy, or grow, and become stronger to eventually provide 70%-80% of normal function for an individual with two healthy kidneys. (This is 7-8 times as much kidney function as is needed to remain healthy and off dialysis.)
  

  A reduction of 20%-30% in kidney function is not associated with an increased risk of developing kidney disease. If, however, the individual who donated a kidney were unfortunate enough to develop a kidney disease later in life, they would be starting at a 20% - 30% deficit in function. A nephrologist will evaluate any potential living donor to be sure that there are no active kidney diseases at the time of donation. But, no one can predict the future. Fortunately, in the United States, the incidence of kidney disease requiring dialysis is quite rare.

• Proteiuria: Individuals who donate a kidney have an increased incidence of protein in the urine. This is called proteiuria. In many people with kidney disease, protein in the urine is a marker for kidney damage. However, in kidney donors, protein in the urine has not been associated with any progressive damage to the kidney.
• Blood Pressure: Kidney donors have a possible risk of increased blood pressure. It has been shown that individuals who have donated a kidney have the same incidence of high blood pressure as the normal U.S. population. Investigators interpret this observation in different ways. Some believe that kidney donation is completely safe. Others feel that, since kidney donors are the healthiest individuals in the country, it is unlikely that they would have high blood pressure at the time of the donation. So if, after donation, they share the same blood pressure as the rest of the population, perhaps kidney donation may be associated with worsening blood pressure.
• Damage to the Remaining Kidney: A concern after kidney donation is damage to the remaining kidney later in life. Obviously, once an individual has donated a kidney, they are relying on the one remaining kidney. Should an obstructing kidney stone or tumor develop, or if the kidney experiences a trauma, it would be more serious than it would in an individual who had two functioning kidneys.