Living Kidney Donation Poses Minimal Risk
for Donors
With recent advancements in transplantation technology and drug
therapies, the average three- to four-year wait time for a traditional
kidney transplant can be virtually eliminated if a patient receives
a living kidney donation.
Living donor transplant is gaining popularity
with patients because kidneys from living donors
offer recipients better chances of long-term survival than cadaver
kidneys. As the shortage of cadaver organs increases, living donor
transplant becomes a more successful – and more necessary – procedure.
Living Donor Eligibility
Living donors are classified as “living-related” or “living-unrelated.” Living-related
donors include siblings, parents, children, aunts,
uncles or cousins; living-unrelated (also called “emotionally
related”) donors include spouses, in-laws,
adoptive parents or children or very close friends.
Although
it seems that a recipient would be less likely
to reject a kidney from a blood-related donor,
kidney transplants from emotionally related donors
can be equally successful thanks to the availability
of newer and more potent immunosuppressive medications,
which block the recipient's immune system from
rejecting the transplanted organ after surgery.
The recipient begins taking immunosuppressants
immediately following transplant surgery and
must take the medication for the life of the
transplanted organ.
The decision to be a living donor to a friend or family member requires careful consideration. The United
Network for Organ Sharing (UNOS) recommends that someone considering living organ donation ask a series of questions, including:
- How do I feel about organ donation?
- Do I know enough to make a logical and educated decision?
- Will donation have an impact on my relationship with the recipient?
- What are the medical risks involved?
- How does my religion view organ donation?
- Am I up to it physically? Are there current aspects of my health that I know should keep me from donating?
Benefits Outweigh Risks
If you do decide to become a living donor, your donation poses numerous advantages for the recipient. According to Donate Life America, these include:
- The recipient does not need to be put on the national waiting list and face a long wait until an organ becomes available.
- Transplants from living donors are often more successful because of extensive pre-testing to ensure the best possible “match” based on medical criteria.
- The transplant can be scheduled ahead-of-time, and the surgery is performed when everyone is in optimal condition for the surgery.
- Living donation frees the recipient from dialysis.
- Increased survival rates. National statistics indicate about a 10 percent increased success rate at one year for living donation.
Compared to the many benefits of living donor transplant for the recipient, the risks involved for the donor are few. Most patients who require a kidney transplant are on dialysis, meaning their kidney function has fallen to 10 percent or less. Dialysis removes impurities and wastes from the patient's blood because the kidneys are unable to do so. Even with one kidney, a healthy person has seven or eight times more kidney function than a patient on dialysis: after donating a kidney, kidney function typically falls to just 75 percent, compared to the 10 percent function of a patient on dialysis.
Donating a kidney does not decrease the donor's life expectancy, nor does the procedure increase the donor's chance of developing kidney disease. In addition, young women who are kidney donors can go through pregnancy and childbirth at no greater risk to them or to their baby than if they had two kidneys.
Living Donor Surgery
During donor surgery, the donor receives anesthesia through an IV line. Once he or she is asleep, a catheter – a small, flexible tube that catches urine so that it can be checked and measured – is inserted into the bladder. The operation itself it called a donor nephrectomy and takes three to four hours. To perform a traditional nephrectomy, the surgeon makes a 10-inch incision below the lowest rib on either the left or right side. Blood transfusions are almost never needed.
As an alternative to a traditional nephrectomy, laparoscopic surgery is also available for donor kidney removal. Laparoscopic surgery can make donating a kidney to a loved one even easier: Patients experience less pain, a shorter hospital stay and a faster recovery time. While there is a six-week recovery period associated with traditional open surgery, the recovery time for laparoscopic surgery is just two weeks.
To perform a laparoscopic nephrectomy, the surgeon makes four small holes underneath the ribcage. The surgical instruments and the laparoscope (a long, slender optical instrument containing a miniature camera) are placed through these holes, and the surgeon removes the kidney through a two- or three-inch lower abdominal incision.
Among transplant organs in the U.S., kidneys are in the greatest demand. With wait times of up to six years for cadaver kidneys, the utilization of living donors has been steadily rising. Most importantly, the decision to become a living kidney donor could increase your loved one's life expectancy. For many patients, post-transplant life expectancy is more than double than if they remained on dialysis.
For more information on living
donor transplant or to schedule
and appointment with a Penn Transplant
Institute physician, call 1-800-789-PENN (7366).
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