For the Recipient
Is a kidney transplant from a living donor better than one from a deceased donor?
Kidney donation from a living donor provides some major benefits including:
- Better match: A donor-recipient match is important during kidney donation. It ensures that the recipient’s body will accept the new kidney.
- Improved long-term transplant kidney survival: Kidneys from a living donor are usually healthier and last longer than deceased donor kidneys
- Faster access to transplantation: Individuals can receive a living donor transplant before starting on dialysis and eliminates the wait time needed for a deceased donation
Does the donor need to be a relative?
Any healthy person can choose to become a kidney donor. The donor does not have to be a relative or even be related to the intended recipient. Through kidney paired exchange, the transplant team ensures that the recipient receives the best transplant for their kidney health.
What is kidney paired donation exchange?
Kidney paired exchange is a transplant option for kidney recipient and donor pairs who are not blood and/or tissue-type compatible. This option allows kidneys to be exchanged between two incompatible pairs to allow for two compatible living donor transplants.
How are living donors matched to recipients in a kidney paired exchange?
The Penn Transplant Institute partners with the National Kidney Registry (NKR) to facilitate living donor kidney transplants. The NKR helps to safely find compatible, well-matched donor-patient pairs from the largest living donor pool in the world. A better match increases kidney allograft survival and is correlated with more kidney life-years post-transplant. Additionally, the patient outcomes from transplants facilitated by the National Kidney Registry exceed the average U.S. living donor transplant outcomes.
For the Donor
Who can be a donor?
To qualify as a living donor, an individual must be in good health, free from any serious medical problems, and in the general age range of 21-70. Donors older and younger will be considered on a case by case basis.
What are the risks involved?
Donating a kidney does not have any long-term effect on health. Donors may experience a slight rise in blood pressure and a small amount of excess protein in the urine following surgery. There is no greater risk of developing kidney failure after donating a kidney than anyone in the general population.
At Penn Transplant Institute, the donor’s safety is the top priority. Risks related to kidney donation include short-term and long-term:
- Long-term risks: There is a slightly increased risk of kidney failure. Following kidney donation, there is a loss of ~ 25-30% of total kidney function. Individuals who donate a kidney have about a 1% chance of developing kidney failure, which is higher than healthy non-donors. However, this risk is still low and is discussed in detail with the kidney specialist who evaluates the potential living donor
- Short-term risks: Surgical complications, including pain, infection, blood loss, injury to other tissue or organs, and even death. These risks are very small but are not zero. Living kidney donor surgeries have very low rates of complications.
Studies have shown that donors typically live longer than the general population because they are selected on the basis of good health and are thoroughly screened prior to donation.
Are there activities that I will not be able to do in the future if I choose to donate a kidney?
Some restrictions do apply following donor surgery, including reducing or eliminating the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) and avoiding any activity that may cause injury to the surgical area.
We also recommend that you continue to see a primary care provider every year for an annual examination after kidney donation. This annual examination should include:
- Labwork to ensure kidney function remains stable
- Blood pressure checks to ensure your blood pressure remains in a normal range
Does the evaluation process have to be completed at Penn?
The entire evaluation process is completed at Penn; however, if the prospective donor lives at a distance, arrangements can be made for some of the tests and appointments to be done locally.
Who makes the final decision on potential donors?
Based on the evaluation results, the Living Donor Transplant team (comprised of nephrologists, nurses, social workers, dieticians and other transplant specialists) decides whether or not to proceed with a living donor kidney transplant as the best therapeutic option.
How am I matched to a recipient?
The Penn Transplant Institute partners with the National Kidney Registry (NKR) to safely find compatible, well-matched donor-patient pairs from the largest living donor pool in the world.
Who pays for the donor's medical expenses?
The recipient's insurance covers all of the donor's evaluation and hospitalization costs; however, it does not cover lost income or employee benefits, transportation costs or personal expenses. The transplant financial advisor coordinator reviews the potential donor/recipient procedures and associated costs carefully prior to the evaluation. As part of the living donor evaluation process, you will also hear about the National Living Donor Assistance Center (NLDAC) as well as other nonprofit financial aid programs that can help eligible living donors with additional expenses. Donor assistance is offered through the National Kidney Registry’s Donor Shield Program.
How long will I be in the hospital?
Most donors remain in the hospital for two to three days.
What is the recovery process like?
Fatigue is common after living kidney donation. It generally takes one month to return to your normal energy level. Donors are not able to drive for 2 weeks after surgery and are not permitted to lift heavy objects for at least 6 weeks. You may need assistance with daily living activities during this time. Walking helps to improve healing and return of strength and energy. We encourage light activity in moderation during recovery.
How long will I be out of work?
Depending on the nature of the work, donors typically return to work between 10 days and two weeks.
What happens if I decide not to become a kidney donor?
At any point, for any reason, the evaluation process can be stopped, including the day of surgery. The recipient will remain active on the transplant list and is free to find another potential living donor.
How do I start the process to become a living donor?
To begin the referral process, please complete the living donor screening form. Once the form is received, you will receive an email with laboratory orders for bloodwork and urine testing which should be completed in a timely fashion. Once the screening form and lab results are received and reviewed, a living donor nurse coordinator will contact you to review the next steps.
For the Caregiver
Do I need to provide a special diet during the recovery period?
Donors do not have to eat a special diet after surgery, as long as the recovery is progressing as expected.
Will the donor have any physical restrictions during recovery that I should I be aware of?
While light physical activity, such as walking, is encouraged following surgery, the donor is restricted from lifting heavy objects for at least 6 weeks. He or she may need assistance with daily living activities such as lifting groceries, transportation, and other household chores.
What medications need to be administered during recovery?
The donor will be prescribed pain medication to manage any discomfort following surgery. Constipation and abdominal bloating are also common after this surgery. Medications are provided to help ease the discomfort of abdominal symptoms.