Living organ donor FAQ

Overall, living kidney donation is safe. Like any surgery, the procedure does have some risks.

During our extensive evaluation process, we review all your risks so you can carefully consider whether donation is right for you. This process helps reduce risks related to donation. By carefully assessing your physical health, mental health, financial situation, and social support, we can identify potential problems before they arise.

Some of the risks of kidney donation include:

• Financial risks: Most medical expenses are paid by the recipient’s health insurance. You may have other expenses related to transportation, lodging, childcare, or lost wages. Our social workers and financial counselors work with you to identify these costs before donation. We can help you apply for assistance through the National Kidney Registry, National Living Donor Assistance Center, and other programs.
• Insurance risks: Some donors have reported problems getting life insurance and higher premiums. But under the Affordable Care Act, health insurers can’t refuse to cover you because you have one kidney.
• Kidney health risks: Studies show that the risk of kidney failure in living donors is very low. In the unlikely event of kidney failure, donors are prioritized for a deceased donor kidney transplant. If you donate through the National Kidney Registry, you’re also prioritized for a living donor kidney transplant.
• Pregnancy risks: Donation may slightly increase the risk of some complications during pregnancy, such as gestational hypertension and pre-eclampsia. If you’re considering pregnancy after donation, your evaluation team will talk to you about your risks.
• Psychological and social risks: While most kidney donors report similar or improved quality of life after donation, some people may experience depression, anxiety, or stress. Penn Medicine offers individualized guidance from our social work and transplant psychiatry team to help you cope with these feelings.
• Surgical risks: Kidney donation carries surgical risks such as bleeding and infection. The risk of a major surgical complication is rare (less than 3 percent or 3 in 100) and the risk of death is extremely rare (.03 percent or 3 in 10,000).

Yes, this is called a non-directed donation. Often, people who want to donate a kidney to a relative or friend aren’t a match. The good news is you don’t need to match your recipient or even have an identified recipient to be a living kidney donor.

Our participation in the National Kidney Registry offers the option of paired kidney donation for donors who aren’t a match for their desired recipient. Your kidney doesn’t go directly to your recipient, but you still get to donate, and your recipient gets a new kidney that’s an excellent match.

If you don’t have a recipient, non-directed donation allows your kidney to go to someone in need on the transplant list.

The time it takes to donate a kidney varies. The evaluation process—which consists of various appointments and medical tests—is the most time-consuming part. It ensures that donation is as safe as possible for you.

Some donors complete their evaluation in less than three months, while others take longer. Most patients tell us that the time it took for their evaluation was appropriate and met their needs.

Once the evaluation is complete, we schedule surgery as soon as possible. Most people are back to normal activities within four weeks after surgery.

Generally, we perform your screening tests at Penn Medicine. Donors who live far away may be able to complete portions of the initial evaluation at a local health-care facility.

You may need to stay in the hospital for up to three days after surgery.

You should be able to return to work within four weeks. However, you may have to avoid heavy lifting for six weeks.

In general, once you recover from surgery, your life after kidney donation will be the same as it was before kidney donation. Compared with people who don’t donate a kidney, kidney donors have a similar life expectancy and a similar or better quality of life.

With the exception of a few minor changes, your life should be the same after kidney donation. Your doctor will recommend you:

• Avoid contact sports
• Don’t take non-steroidal anti-inflammatory drugs (NSAIDs) like Motrin®, Advil®, and Aleve®
• Schedule annual routine appointments with your primary care provider to check your blood pressure and kidney function
• Talk to your OB/GYN if you plan to become pregnant

Though uncommon, kidney donors may experience depression, anxiety, or stress. If this happens, let us know. We have one-on-one counseling or support groups to help you cope.

If at any point a prospective donor chooses not to pursue the evaluation process they may stop, for any reason. This decision is private health information and protected by federal HIPPA regulations. We inform the recipient that the donor isn’t suitable. The recipient is also free to find another potential living donor at any time.

Our donor evaluation process was designed to protect the safety, health, and well-being of donors. Living liver donation is a surgery and as such, it has some risks. While serious complications are rare, as with any surgery, they are possible. We outline all risks for the donor before the evaluation.

National studies show that approximately one-third of donors have some sort of post-operative complication, but the great majority of complications are minor and reversible. Potential serious side effects include bleeding, infection, liver failure, injury to the bile duct, complications from general anesthesia, and death. The risk of death from being a living liver donor in the United States is less than 0.2 percent, which is similar to the risk of being involved in a motor vehicle accident.

We have a special procedure in place to meet the needs of distance liver donors and minimize their time away from home. However, you’ll have to stay in the Philadelphia area approximately three to four weeks after discharge from the hospital to ensure you’re recovering well. We offer lodging at the Clyde F. Barker Penn Transplant House, a guest house for transplant patients and their families and caregivers.

Although the recipient’s insurance covers all medical expenses, it doesn’t always pay for the donor’s travel, lodging, and meal expenses during the evaluation and transplant process. We may be able to arrange additional assistance.

Generally, all screening tests are performed at Penn Medicine. Donors who live far away may be able to complete portions of the initial evaluation at a local health-care facility.

Most donors remain in the hospital for approximately five days.

After leaving the hospital, we encourage living liver donors to slowly resume normal activity. Donors aren’t able to drive for six weeks after discharge and aren’t permitted to lift heavy objects and therefore may need assistance during their recovery.

We encourage donors to be active at home one week after surgery and gradually increase their strength. The typical recovery period is eight to 10 weeks.

Yes. In most cases, your liver will regrow to 90 to 95 percent of its original size within three months of surgery.

Many living liver donors return to work on a part-time basis as early as four to six weeks after surgery. Heavy lifting or strenuous physical activity is restricted for six weeks or when your physician clears you to do so. Returning to full-time work may take up to two months, depending on the type of work you do.

A follow-up appointment takes place one week after discharge with a focus on ensuring proper healing and pain management. You’ll have two follow-up appointments within the first month. If you’re recovering as expected, you’ll have follow-up appointments at three months, six months, one year, and two years after surgery.

We encourage you to receive your follow-up care at Penn Medicine. However, we can coordinate your care with local centers if needed.

Becoming a living liver donor will have no impact on having children in the future.

There are certain liver conditions that could reoccur. We make every effort to fully inform the donor and recipient of all treatment options available and the projected success rate of each.

If at any point a prospective donor chooses not to pursue the evaluation process they may stop, for any reason. This decision is considered private health information and is protected by federal Health Insurance Portability and Accountability Act (HIPAA) regulations. We inform the recipient that the donor isn’t suitable. The recipient is also free to find another potential living donor at any time.

For the kidney recipient, the benefits of receiving a kidney from a living donor compared to a deceased donor include:

• Better match: A donor-recipient match is important during kidney donation. It ensures that the recipient’s body will accept the new kidney. Kidneys donated by family members are more likely to be a better match with a reduced chance of rejection.
• Faster recovery: Living donor kidneys usually start working immediately after transplant, compared with deceased donor kidneys that may have delayed function. This leads to a quicker recovery after transplant.
• Improved survival: Kidneys from a living donor are usually healthier and last up to two times longer than deceased donor kidneys.
• Less time on dialysis: Recipients can get a living donor transplant before starting dialysis, which leads to better long-term health.
• Convenience: You can schedule the donation for a time that works well for both the donor and recipient.

Our participation in the National Kidney Registry offers the option of paired kidney donation for donors who aren’t a match for their desired recipient. Your donor’s kidney doesn’t go directly to you, but you receive a kidney from someone who is a match.

UNOS policy permits patients to be added to the transplant waiting list at multiple centers. Additional information about multiple listing can be found on the UNOS website.

The Model for End-Stage Liver Disease, or MELD, is a scoring system used for prioritizing allocation of liver transplants. It’s based on how sick the potential recipient is, with sicker people having priority.

However, Penn Medicine recognizes that many people have symptoms that severely impact their quality of life yet aren’t reflected in their MELD score. Living donation offers people the option of transplant prior to getting very sick, regardless of their MELD score.

Most people who are candidates for liver transplantation qualify for adult-to-adult living donor transplantation. However, people with certain conditions may not benefit from a liver from a live donor. For this reason, we evaluate each recipient on a case-by-case basis.

Living liver donation offers many benefits. The main advantage is that the recipient doesn’t have to wait for a liver to become available and avoids the risk of dying before a deceased donor liver becomes available. With a living donor, surgery can be scheduled at a time that’s optimal, for both the donor and the recipient, based on the recipient’s health.

Recent studies demonstrate that recipients of living donor liver transplants have as good—and sometimes better—outcomes than recipients of deceased donor liver transplants.

The donor doesn’t have to be blood related. Any healthy person can give a friend or relative the gift of life. However, donors typically have some sort of a relationship with the intended recipient or their family.

UNOS policy permits patients to be added to the transplant waiting list at multiple centers. Additional information about multiple listing can be found on the UNOS website.