Living Donor Kidney Transplant

For children who need a kidney transplant, there are a number of advantages to having a live kidney donation — one that comes from a living person. Primarily, the wait time for the transplant is much shorter. That means surgery can be planned before your child becomes too ill.

Receiving a kidney from a living donor also eliminates the time between procurement of the organ and transplantation. If an organ has been outside the donor’s body for too long it might not work as well. A continued shortage of deceased donor kidneys has also led to an increased reliance on living donor transplantation.

Donor qualifications

If you are considering being a living donor for a young friend or family member who needs a new kidney, you must meet certain qualifications. While you do not need to be related to the recipient, you must:

  • Be between 21 and 60 years of age
  • Be physically fit and in good overall health
  • Have no significant medical problems
  • Have not had major abdominal surgery

Living donor evaluation

Potential donors must undergo a thorough evaluation to ensure they can tolerate the procedure and that their kidney is appropriate for the recipient. This evaluation takes place at the Penn Transplant Institute at the Hospital of the University of Pennsylvania (HUP). Since most living organ donors are adults, CHOP’s partnership with HUP ensures the best care for both donor and recipient. The evaluation includes, but is not limited to:

  • An appointment with a HUP social worker and a HUP living donor advocate
  • Initial blood type and tissue typing, blood crossmatch with potential recipient (arranged through transplant coordinator)
  • Physical examination that includes height, weight, pulse and blood pressure measurement (This is done by the donor's primary care doctor.)
  • Gynecological examination and Pap smear for all women
  • Mammogram for all women over 35
  • Urine sample and culture
  • 24-hour urine collections, done twice (All urine in a 24-hour period must be collected for accurate results)
  • Blood work
  • PSA for males over 45 years of age
  • Electrocardiogram (EKG)
  • Chest X-ray
  • Renal ultrasound
  • Renal angiogram

After the evaluation, the potential living donor will have an appointment with a nephrologist at HUP for a physical exam and discussion of donorship. They will also have an appointment with the living donor surgeon to discuss surgical options.

The above criteria are all part of the initial evaluation, but keep in mind that each case is unique. If you are considering living donation, we encourage you to speak with a transplant team member by calling 1-877-ORGAN50(674-2650).

Living donor kidney transplantation surgery

The living kidney donor operation generally takes six to eight hours, with additional time for anesthesia preparation. When the surgery is complete, the living donor remains in the recovery room for observation before being brought to the specialized transplant floor for post-operative care. The living donor usually remains in the hospital for three to seven days.

Health risks to living donors

At the CHOP Transplant Center, a specialized team of surgeons is dedicated to the living donor operation and returning the living donor to a fully functional and healthy life. Most of the time, the operation goes very smoothly for a healthy living donor. Death from living kidney donation is very rare, but any procedure involving the kidney has some risk. In addition, every time anesthesia is given or someone has surgery, there is a possibility of a complication.

The most common risks for living kidney donation include bleeding, infection and incisional hernia. There is always the chance that re-operation is necessary. The kidney specialist talks to a potential living donor about her health, test results and risk of problems with living kidney donation.

After recovery from surgery, the living donor is able to return to normal routine — work, drive a car and play sports as before. Living donation does not change life expectancy. Current research shows that living donation does not increase a living donor's risk for kidney failure or put the living donor at more risk for future health complications.

Other considerations

  • Most people stay in the hospital three to seven days after surgery and can return to work in three weeks.
  • Both the living donor's insurance and the recipient's insurance cover most of the cost of living kidney donation and testing. However, each insurance plan is different.
  • Some costs may not be covered — pay lost from taking time off from work, travel costs and insurance "co-pays" required by some plans. A social worker and a transplant financial counselor can discuss specific insurance coverage and reimbursement concerns.
  • Insurance companies have different rules about providing health and/or life insurance to people who have one kidney. The potential living donor must speak with a social worker about these kinds of issues.
  • Living kidney donors can work in most types of employment without a problem. However, the military and some police and fire departments may not take individuals who have only one kidney.
  • There are no direct health benefits to the living donor, but there may be psychological benefits. Many living donors feel rewarded and very happy from helping a loved-one or person in need. Many times they can see the life of that person improved greatly after the transplant.

How to ask someone to be a living donor

Asking someone to donate an organ is a major decision, but it can be a lifesaving effort, as well. Possible living donors can include family, friends co-workers and acquaintances. Therefore, it's important to inform those people of your child’s need for an organ transplant. Often, just discussing your child’s situation with these individuals will elicit volunteer living donors.

If no volunteers surface, here are some suggestions for initiating a conversation about your need for a living donor:

  • Discuss the details and benefits of living donor kidney transplantation.
  • Ask in a way that’s heartfelt, but doesn’t pressure the person.
  • If a person declines, do not push the issue.
  • If she seems interested or says yes, provide her with more information about the details of donating, including requirements for eligibility, and inform her there would be no medical costs for her.
  • Give the donor time to consider whether this is the right decision. Organ donation is a life-altering decision which may or may not be appropriate for a person’s particular situation. Offer him additional information and support when needed.
  • Provide the potential donor with our contact information. Reassure the person that any contact with the Transplant Center is confidential and doesn’t commit her to donating. Our number is 1-877-ORGAN50(674-2650).

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