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Giving a kidney to a family member can
be one of life's most rewarding experiences. For many families, this gift
has meant restored health for the person receiving the transplant and
also closer family ties. The decision to donate a kidney is a serious
one. It helps to know as much as possible about the potential benefits
and problems.
Are there
different kinds of kidney transplants?
Kidneys for transplantation may come from a living donor or a person who
has recently died (deceased). Generally, a living-donor kidney is more desirable than a deceased-donor kidney.
Why are
living donor kidneys preferable?
Because kidneys from live donors are removed under ideal conditions and
the donor is in optimal health, these kidneys usually function immediately
and the recipient usually has less rejection. Therefore, the recipient
experiences better kidney function for a longer period of time. In addition,
the recipient doesn't have to wait for a deceased kidney to become available.
Who can
be a living donor?
First and foremost, the donation of a kidney must be a voluntary act.
Family members or friends who are in good health and are willing donors
are considered. The individual circumstances of each potential donor are
discussed privately and testing is started to determine compatibility.
Can kidneys
be donated by non-related individuals?
Non-related donors, such as spouses or friends, are accepted as living
donors. In these cases, careful consideration is given to such factors
as the motives and the psychological implications
for both donor and recipient. As in all transplants, the patient should
discuss these issues with the physician or transplant nurse coordinator.
Each case is evaluated
on an individual basis.
What makes
a good match between a kidney donor and recipient?
A good match is obtained when the donor and recipient have compatible
blood types
and tissue. The more closely related two people
are, the more likely their blood and body tissues will be alike.
What evaluation
does a donor require?
To determine the health of the donor, several routine tests are conducted.
These tests can be done on an outpatient basis, and include the following:
- Blood tests to determine blood type and tissue
compatibility
- An interview with the social worker to ensure there
is a healthy motive to donate
- Blood, urine, and viral testing
- A complete history and physical exam
- Chest x-ray
- CT angiogram of the kidneys (x-ray of the blood
vessels of the kidneys)
What happens before the
operation?
Generally, the donor and recipient are seen in the transplant clinic several
days before the operation. At this time, a final physical examination
and blood tests are performed. The surgeon who will be removing the kidney
discusses any final questions or concerns the donor and recipient may
have. You will not need to go to the hospital until the morning of surgery.
What happens to the donor
during the surgery?
Shortly before going to the operating room, the donor will be given medication
to help him or her relax. A general anesthetic is administered in the
operating room to put the donor to sleep during the surgery. At Hennepin
County Medical Center, removal of the kidney is usually performed with
the aid of a laparoscope; this is a much less invasive, and less painful
way of removing the kidney. If the donor is unable to have the kidney
removed with the aid of the laparoscope, the surgeon will make an incision
on the side from which the kidney is to be removed. The kidney is removed
and taken to an adjoining operating room where the recipient has been
prepared to receive the new kidney. Typically, the preparation for the
surgery and the operation itself take approximately three hours. After
the surgery, the donor is brought to his or her hospital room.
How risky is the operation
for the donor?
All major operations have some risks. The usual risks are bleeding, infection,
or blood clot formation. Fortunately, they seldom occur. Everything possible
is done to prevent these problems.
How do donors feel during
the recovery period after the surgery?
Although each situation is unique, donors typically have a rapid and uneventful
recovery. Following the conventional operation, the donor feels tired,
but this is a natural body reaction to surgery and the general anesthetic.
If removal of the kidney is performed through an incision, there is pain
lasting several days, and discomfort for several weeks as the muscles
around the incision heal. The discomfort decreases as the donor becomes
more physically active. Pain medications are given to lessen the discomfort.
At HCMC, most donors are able to have the surgery laparoscopically, which
makes the recovery significantly shorter and less painful.
How long do donors remain
in the hospital?
If the kidney is removed laparoscopically, most donors go home in two
days. If an incision on the donor's side is used to remove the kidney,
most donors will be in the hospital for four days.
When can the donor return
to normal activity?
The rate of recovery and return to normal activity is different for everyone.
If laparoscopic surgery is performed, the donor has minimal pain and returns
normal activity much sooner. With open nephrectomy, donors typically experience
tenderness and stiffness as the incision heals. Generally, donors are
advised to avoid heavy lifting for six weeks after hospitalization.
After donation, living donors continue to have normal
kidney function. No lifestyle changes or medications are necessary after
one kidney is removed.
Will giving a kidney
affect the ability of a donor to become pregnant or father a child?
There is no evidence that donating a kidney has any effect on the ability
to have children.
Is a donor more likely
to develop kidney disease or other health problems later in life?
At present, it does not appear that kidney donation places an individual
at risk for future health problems.
Who pays for the donor's
medical expenses?
The donor's medical expenses related to the donation are paid for by the recipient's health insurance.
Does a donor have expenses
that are not paid by the recipient's insurance?
Generally, public and private insurance programs do not pay the travel,
meals, lodging expenses, or lost income that donors incur. To cover the
loss of income, many donors have used sick time from work, and others
have used their vacation time. Some families pool their resources to help
the family member who is donating.
Do some donors have trouble
making the decision to give a kidney?
Some people make the decision instantly, with few worries or problems.
Others must go through some soul-searching before deciding. It is normal
for a potential donor to have concerns about giving a kidney or to feel
surprised about his or her own reluctance. The only "right" decision is
the one with which the potential donor feels most comfortable.
The transplant
staff will help in a nonjudgmental and professional manner. The trans-
plant
social worker talks with every potential donor (and spouse or family) to
make sure the decision is the right one for the donor.
How do kidney donors
feel about their experiences?
In a survey, living-related donors were asked, "If you could reconsider
donating your kidney, would you make the same decision?" Ninety-one percent
said "yes" without any reservations, while an additional five- percent
stated that they would probably make the same decision. Three percent
of the donors were unsure of the decision they would make, and one percent
indicated that they would not give their kidney if they had to do it all
over again.
Would it be possible
to talk with someone who has donated a kidney?
Yes, we know of many living donors who are willing to discuss the process
from a personal perspective. We can arrange to put you in contact with
a living donor.
A final note to the potential
living donor:
This information was developed to give you basic information on living
kidney donation. It should help you begin to consider the possibility
of becoming a kidney donor. Feel free to discuss this possibility with
your family and friends, as well as with the transplant staff. Most important,
remember that, when all is said and done, the only "right" decision is
the one with which you feel the most comfortable.
For more information about living donors, contact the
HCMC Transplant Coordinators at (612) 347-5931 or toll
free at 1-888-345-0816.
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