Living Donation

Your gift is the miracle they're waiting for.

What is Living Donation?

Living donation is when a person who is alive donates an organ to a person in need of an organ. Living donors usually donate a kidney or a part of their liver.

Who Can be a Living Donor?

While the most common organ donated by living donors are kidneys, living donors may also donate part of their liver, lung, pancreas, or intestine.

  • Kidney Donation: A kidney transplant is the most common living donor procedure. Living with one healthy kidney is enough to support a healthy life for both the donor and the recipient.
  • Liver Donation: A living donor can donate part of their liver. The living donor's liver will then restore itself (regenerate) and the recipient's liver will, too.
  • It is much less common for other organs to be donated, such as a lung, part of a pancreas, or an intestine.
  • Living donor transplants end the wait for an organ from a deceased donor. The best-case scenario is to help a kidney transplant candidate get an organ transplant before they need to begin dialysis.

Types of Living Donors

  • Directed donor: A person who wants to donate an organ to a specific recipient.
  • Nondirected donor: A person who wants to donate an organ but does not have a specific recipient in mind. A nondirected donor expresses interest in donating to a transplant hospital. Nondirected donors are sometimes called anonymous donors or altruistic donors.
  • Paired donor: A person who donates an organ to someone they do not know through a kidney exchange program. They do this so another living donor will give a kidney to someone they know. Kidney exchange helps to make medically compatible, donor-recipient combinations possible.

Becoming a Living Donor

Before any in-depth physical, laboratory, or psychological evaluation is done, transplant centers will explain the living donation process. This will include information about the medical evaluation and process to determine your suitability as a living donor, the surgery, and post-operative care. They will also explain the financial aspects of donation. This includes who covers the costs of medical care and expenses that you, as the living donor, may have to pay.

The next step in the process is a complete medical history evaluation at the transplant center. This involves a detailed questionnaire to gather information about your general health, lifestyle, and any preexisting medical conditions.

A complete medical history and physical exam are done to see if there are any issues that may make living donation ill-advised (unwise). Testing will be done to assess the donor's overall health, including heart, lungs, and kidney function. Testing includes:

  • Blood type testing: To have a successful transplant, the donor's and recipient's blood types must be a match. This is called "matching blood type compatibility." Blood tests let the transplant hospital know whether you and a transplant recipient have compatible blood types. Both of you must have compatible blood types to reduce the risk of rejection.
    Donors are tested for infectious diseases such as HIV, hepatitis, and others. This is done to protect the health of both the donor and the recipient.
  • Crossmatching: A more in-depth evaluation involves crossmatching. This determines if the tissues and antibodies of the donor and the potential recipient are compatible. Crossmatching further reduces the risk of organ rejection and improves outcomes.
  • Other blood tests: This includes blood chemistries, blood counts, tests for certain infectious diseases, and immune system function.
  • Psychological evaluation: Donors speak with social workers and/or psychiatrists to ensure they fully understand the emotional and psychological aspects of donation. A complete history is taken to assess for any psychological issues that may make donation unwise. This ensures that the decision to donate is voluntary and not coerced (forced).

More testing may be needed depending on a person's medical history. Other tests that may be needed include:

  • X-rays, scans, and ultrasounds to look at the structure and health of the specific organ to be donated.
  • Chest X-ray and electrocardiogram (EKG), and radiologic testing, as well as a 24-hour urine sample to look at your kidney function.

Throughout this process, an Independent Living Donor Advocate will be looking out for your needs. They will ensure that your interests are protected and represented.

After all testing and evaluation activities have been completed, a multidisciplinary team of health care professionals reviews the results of all tests and assessments to determine if the donation can proceed. The health care staff involved includes transplant surgeons, nephrologists (providers who specialize in kidney care) or other health care providers, social workers, pharmacists, dietitians, and others. If approved, the donor provides informed consent (agreement) to go ahead with the donation.

Outcomes of Living Donation

Living organ donors can improve the chances of a successful transplant.

For example, kidneys from living donors generally have high success rates:

  • More than 98% of transplanted kidneys from living donors are still working one year after transplant.
  • On average, living donor kidney transplants work longer than kidney transplants from deceased donors.
  • The outcomes for living donor liver transplants, are as good or better than outcomes for liver transplants from deceased donors.

Living organ donation not only saves lives, it also enhances the quality of life for recipients. It allows them to regain their health, independence, and the opportunity to fully enjoy life. A living donation can ease a patient's burden of having a chronic illness and/or being dependent on medical treatments like dialysis. Recipients often gain a renewed sense of hope and gratitude with their second chance at life.