How to Become a Kidney Donor

Currently in the United States there are over 100,000 people who are waiting for a donor kidney and the average wait time for a kidney could be five to ten years, depending upon what blood type you are.  When you also consider that only about 20,000 kidney transplants are performed each year, it’s easy to understand why the shortage of kidneys available for transplantation is considered a public health crisis. Every year almost 5,000 people on the transplant waiting list die waiting for a kidney transplant.  If you are interested in making a real difference in the life of one of these people, giving them back their health and perhaps even saving a life, I hope you might consider kidney donation, and give the gift of life to someone waiting for someone like you. There are two ways kidneys are donated for transplant. You may in life designate your organs for donation upon your death, or you may consider becoming a living donor, to a relative, friend, or even someone you have never met, but whose life you may change.  

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Register as a Organ Donor

‍The process to allow your organs to be taken to donate after death is very simple with few steps to follow. Visit the Donate Life America website www.donatelife.net and join the online registry for donation for your state. You can also declare your intention to be an organ donor on your driver's license. Also, have a conversation with loved ones and family members letting them know you wish to be an organ donor, and that you have registered.  It is never pleasant considering the death of someone you love, however knowing all the good that can be done in other people's lives can make it a conversation worth having.

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Become a Living Donor

‍The second kind of donation is from a living donor. A kidney transplanted from a deceased donor lasts for an average of 12-15 years.  However, a transplant from a living kidney donor lasts an average of 15-20 years.  There are other advantages to transplanting from a living donor. If a transplant is done between family members who are genetically similar it lessens the risk of rejection by the recipient, and a kidney from a living donor usually begins to function immediately once transplanted.  This is due to the short length of time the kidney is out of the body as compared with those from a deceased donor, which sometimes take time to begin to function again once transplanted.  As a result, the patient must continue to have dialysis until the kidney begins to function.  Another advantage is the fact that potential donors are tested ahead of time and allow for the best possible match. The transplant can then take place at a time that is convenient for both the donor and the recipient.  If you have two healthy kidneys you may be able to vastly improve or even save a life as a living donor.  There are two main types of living donation; directed donation and non directed donation. 

‍Directed donation is usually done to provide a kidney to someone you know; a family member or a friend who is in need of a life saving gift.  Non directed living donation is when a kidney is donated with no intended recipient in mind, the recipient is selected based purely on medical compatibility.  This is also called altruistic donation. These altruistic donors who donate anonymously, are today becoming more common.  

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Video

In this video developed by TriStarHealth, the process to provide donate a live kidney is outlined. The transcript of the video follows.

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Video Transcript

Hello.

And thank you for your interest in learning more about the live kidney donor process. This video will provide an overview of the medical, surgical, psychosocial, and financial considerations you need to be aware of in order to donate your kidney.

This video will also provide information about the surgical procedure, recovery, and required follow-up if you donate.

On average, about 6,000 people each year become living kidney donors in the United States. In general, live kidney donation is a relatively safe procedure. But like all surgeries, there are associated risks. Some risks are expected and considered minor such as pain, a surgical scar, fatigue, or other symptoms like bloating and nausea.

Additional potential risks can be more severe such as wound infection, bowel obstruction, hernia, blood clot, pneumonia, or nerve injury. Though extremely rare, in some cases, you could experience kidney failure and need dialysis immediately after donation. This could be short term, most common, or permanent.

When these rare events occur, current policy gives living donors priority on the national waiting list for a kidney transplant. As with all types of surgery, death can occur. The risk for disease or death as a kidney donor could be impacted by factors such as age, high blood pressure, obesity, or other medical conditions.

The team will discuss these factors that could affect you. There are potential psychosocial risks after donation. These risks include problems with how you feel about your body or what it looks like, changes in your lifestyle, problems with depression, fear, stress, anxiety, or feelings of sadness if the transplant recipient becomes ill or dies.

Your transplant recipient's recovery might not be as expected. For example, the kidney transplant may not work right away or new medical problems could arise. In rare cases, the recipient could even die. The chance of these things happening to your recipient may be higher than compared to other transplant candidates.

The transplant team considers the recipient's risks when determining transplant eligibility and may determine the benefit of transplant is greater than the risk of dialysis. Unless the transplant candidate agrees, their medical information is confidential and cannot be shared with you.

Each transplant programs chooses potential donors and transplant candidates based on their own guidelines, practices, and judgement. The transplant team not only takes into consideration your health at the time of donation, they also consider how donation may impact your future health.

Here are some things to consider. On average, you will permanently lose 25% to 35% of your kidney function after donating. Although this may sound like a lot, one healthy kidney can work just as well as two.

Your risk of having kidney failure later in your lifetime is not any higher than it is for someone in a general population of a similar age, sex, or race. However, you are more likely to have kidney failure than healthy people who are not donors.

If you are a young donor, 18 to 40 years old, determining your likelihood of developing chronic kidney disease or kidney failure later in life is harder to predict.

Chronic Kidney Disease (CKD), if it occurs, often starts in the middle of your life, 40 to 50 years old, and may not progress to kidney failure until after age 60. For women who donate and become pregnant afterwards, the risks for conditions known as pre-eclampsia and gestational hypertension, high blood pressure during your pregnancy, are increased.

If you damage your remaining kidney that you do not donate, you may be at high risk for developing chronic kidney disease which could transition into kidney failure. If this occurs, you will need medical treatment such as dialysis or transplant.

You will also need to take into consideration how the kidney donation as well as potential complications could affect you financially. Here are some things to consider. Living kidney donors should have annual checkups. The donor may be responsible for these costs. You will be required to take time off from work for the surgery and recovery.

This could potentially result in loss of income or employment. You may have potential restrictions on acquiring future employment. You may have difficulty obtaining, maintaining, or affording health insurance, disability insurance, and life insurance.

If you experience future health problems, these may not be covered by the transplant recipient's insurance. Although there are many important aspects to consider, remember, you have a transplant team and living donor advocate to answer your questions and address any concerns.

Your surgeon will determine the best surgical approach to remove your donated kidney. Nearly all living donor operations are performed laparoscopically. It is a minimally invasive surgery that uses small incisions to remove the kidney with the help of a special camera called a laparoscope.

Your surgeon will discuss with you prior to the surgery which method will be used and go over the risks involved.

After surgery, you can expect to spend one to two days in the hospital. The recovery period after donation is different for every donor. On average, it takes two to six weeks for recovery. The transplant team will provide instructions and things to avoid during your recovery.

These include lifting heavy objects, strenuous exercise, and driving. Donors must agree to participate in follow-up care. This care is conducted shortly after your surgery around six months, one year, and two years after donation at the direction of the transplant team.

Follow-up care may include physical examination, laboratory testing, and health screening questionnaires. This care is necessary to monitor your health and provide medical treatment if needed. During this follow-up, like any medical checkup, if an infectious or sexually transmitted disease is discovered, the hospital may need to report it to local, state, or federal health authorities.

Additionally, disclosure to the transplant recipient's hospital may be required. Your information will be kept confidential unless otherwise required by law.

At the end of your two-year follow-up with the transplant team, you should continue to see your primary care physician on a yearly basis. If you or your primary care physician have concerns related to your donation at any time, our team is here to help.

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Inspiration

In this TEDx Speech, Sue Volpe shares her journey where she donated a kidney to a life long friend.

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Resources

‍Transplantation today is highly successful and success rates continue to improve.  The United Network for Organ Sharing (UNOS) website can provide you with statistics on every transplant center in the United States. You can visit their site at www.unos.org   

‍The National Kidney Registry has the largest paired exchange program in the world.and also provides donor shield protection for donors, reimbursement for lost wages, travel and lodging.  The family voucher program protects a donor's family in the event a donor's family member ever needs a transplant.  You can visit them at www.kidneyregistry.org  for more information. 

‍The National Kidney Foundation invites you to start a conversation with them, you can visit their site at www.kidney.org  or email any questions you have to nkfcares@kidney.org  they also have a toll free number for you to call at 1-855-653-2271.

‍Lastly, you may also contact a transplant center in your area to find more information on being a living donor.  If you need help finding the closest transplant center, The Organ Procurement and Transplantation Network ( OPTN) website has a list of all transplant centers in the United States.  Visit them at https://optn.transplant.hrsa.gov  

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References

The National Kidney Foundation

Donate Life
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About the Author

Monica McCarthy has bachelors in Political Science and Criminal Justice from Central Washington University.  A majority of her career was spent as a political consultant.   She currently works at KidneyLuv as a staff writer.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.

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