Traditionally, cadaver organ donors (a healthy person who died suddenly after an accident or illness) were exclusively used for kidney transplants. However, due to a shortage of cadaver donor organs, the number of patients waiting for a kidney transplant in the United States has grown dramatically over time. Transplant candidates are forced to endure longer waiting times and therefore, may become quite ill before they receive an organ, and in some instances, too ill to withstand transplant surgery.
- What is a living donor kidney transplant?
- Who can receive a living donor transplant?
- Who can be a donor?
- What tests are required for a donor?
- What are the risks to the donor?
- What about insurance coverage?
- What do I do first?
Living donor kidney transplantation is an option for many patients. This option allows for a patient to receive a kidney from a living person before they become too ill.
In a "living donor kidney transplant" a healthy donor kidney is removed for transplantation into the recipient's body. With a living donor organ, the need to wait for a cadaveric donor organ is eliminated. This technique has been performed for many years by kidney transplant surgeons and has been perfected over time.
The decision as to whether a patient is a candidate for living donor transplantation is made jointly by the patient and the multidisciplinary transplant team. Factors that will influence the decision are the medical and psychosocial condition of the patient, as well as the availability of a donor organ.
The first requirement is that the donor be an adult, in good health, with a blood type that is compatible with that of the recipient. In addition, both of the donor's kidneys must be healthy in order to ensure that the donation of one kidney is not harmful for the donor. To be a donor, one must donate of their own free will, with full knowledge of the risk and potential complications of the surgical procedure and with only a desire to aid the recipient.
A number of tests, including blood and urine, will be required to verify that a potential donor is entirely healthy and does not show evidence of kidney disease or other conditions that may prevent such a donation. A kidney specialist, not involved in the care of the patient, is consulted to assess the health and suitability of the potential donor. As with patients undergoing evaluation for kidney transplant, potential donors will be interviewed by a social worker. Any medical, social or psychological issues identified may preclude an individual from donating.
If the potential donor successfully passes the initial screening, then he or she will undergo more extensive testing before the transplant surgery is scheduled. A special MRI of the abdomen will be obtained to accurately assess the size of the kidney, as well as other aspects of the patient's anatomy. Other pre-surgery tests, such as an EKG and chest X-ray, will also be performed.
A very frank discussion of the potential risks and complications of such a donation will occur early in this process and will include further explanation of tests required. If at any time a donor wishes to reconsider donation for any reason, his or her decision will be honored and respected.
The Kidney and Pancreas Transplant Program offers laparoscopic donor nephrectomy, a minimally invasive procedure in which a kidney is removed via a small opening. As with any surgery, there are potential risks and complications. A blood transfusion may be necessary, therefore the donor will be encouraged to donate his or her own blood in the event that they require a transfusion. Infection, a possibility after any operation, is uncommon. The medical team provides a constant surveillance to detect and treat any infection that might occur after the surgery. A complete discussion designed to address all questions and concerns that the potential donor might have will occur before the patient donor makes a final decision.
Our financial coordinator will review each candidate's insurance policy for organ donation benefits. There is a long history of living donor kidney transplantation in the United States and therefore, most insurance carriers are quite familiar with the concept and are willing to provide coverage.
Individuals considering becoming a kidney donor can begin the process or obtain additional information by calling the Kidney and Pancreas Transplant Program at Cedars-Sinai Medical Center.
