Living Kidney Donor
Living Kidney Donor | Living With One Kidney | Advantages to Transplant l Donor Medical Evaluation l Donor Expenses
Living Kidney Donor
The Pediatric Kidney Transplant Program at Cincinnati Children's Hospital Medical Center works to identify kidney transplant donors.
All living donors must be healthy and have excellent kidney function.
Acceptable living donors are usually between 18 and 60 years of age and have blood and tissue types compatible with the recipient.
If a potential donor's blood type does not match the recipient's blood type, donation / transplantation may still be possible, for example, through a paired donation program.
Most often the living donor is a close relative of the recipient, such as a parent, sibling, aunt, uncle, or grandparent. Sometimes, though, living unrelated donors with other ties to the recipient, such as an adoptive or step-parent or a family friend could also be matching donors.
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Paired Donation
Paired donation is a program that allows individuals who wish to give a kidney to their loved one but cannot because they are incompatible (they have the wrong blood type or their loved one has immunity to their kidney) pair up with other incompatible donors / recipients. The kidneys are exchanged between the pairs. Cincinnati Children's Hospital Medical Center participates in such a program; The North American Paired Donation Network.
Living With One Kidney
People who give a kidney usually continue to live a normal, healthy life after the donation. However, there appears to be an increased risk of high blood pressure and extra protein in the urine beginning several decades after giving a kidney. Moreover, the decision to donate one kidney obviously results in an otherwise not needed operation, which leaves the donor with one instead of two kidneys. Consequently, the very unlikely but possible loss of the remaining kidney later in life (e.g., in an accident or because of a tumor) could leave the donor her- or himself in need of dialysis and transplantation.
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Advantages To Living Donor Kidney Transplantation
A kidney from a living donor often has advantages over a cadaver kidney:
- People who receive a kidney from a living donor don't have to wait until a kidney becomes available. Living donation allows for the operation to be scheduled at a convenient time.
- Kidneys from family members are more likely to be good matches, although there is no guarantee.
- Kidneys from living donors don't need to be transported from one site to another, so the kidney is in better condition when it is transplanted and it usually starts working right away.
- Living donation helps people waiting for deceased donor kidneys by lowering the number of people on the waiting list.
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Living Donor Evaluation
Medical Evaluation
A medical evaluation is done by an adult internist or nephrologist to determine that the donor is currently healthy and not at apparent risk for future kidney problems. The work-up involves:
- Blood and urine tests
- EKG
- Chest x-ray
- TB skin test
- Physical exam
Female donors should also have a current Pap smear and mammogram done. If the donor lives out of town, arrangements can usually be made to have the medical portion of the donor evaluation done locally.
Donor Hospitalization
The donor is admitted to Cincinnati Children's on the morning of the transplant. The length of the hospital stay is usually 3-4 days.
Donor Recovery
The donor's recovery time depends on which type of surgical procedure they have but most donors are able to return to work within 4-6 weeks after the surgery. The donor surgeon can answer more specific questions at the time of the donor's surgical evaluation.
Kidney CT Angiogram
The CT scan of the kidneys is done to be sure that the donor has two normal appearing kidneys and to evaluate the blood vessels that supply the kidneys. The donor surgeon uses this information to determine which kidney will be removed and which surgical procedure will be used to remove it. Occasionally, if the CT scan does not give the donor surgeon enough information, a dye study of the blood vessels feeding the kidneys (arteriogram) may be necessary.
Psychiatric Evaluation
The donor will meet with an adult psychiatrist or psychologist to make sure that they are mentally and emotionally ready to be a donor and to explore their understanding of informed consent regarding their donation.
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Donor's Medical Expenses
The donor will be given a billing instruction letter at the start of their evaluation which gives directions to all of the providers along the way of their evaluation, surgery, hospital stay, and follow-up as to how to bill the recipient's insurance.
Cincinnati Children's pays all providers at the time of service and is reimbursed by the recipient's insurance at the time of transplant. The donor's health insurance should not be billed for any kidney donation expense.
There is, though, no reimbursement to the donor for travel and lodging expenses, lost wages, child care or daily living expenses that may be incurred during the donation process.
The Live Donor Transplant
Once the donor has been approved, a transplant surgery date is scheduled for a time that works for both the donor and recipient.
Additional Tests / Appointments
The donor will need to have a pre-op physical exam done by his/her primary care physician within one week of the transplant surgery date to make sure that he/she is not sick at the time of surgery.
Also, a few days before the transplant, the donor and recipient will need to have a blood test done for a final crossmatch. This result must be negative, meaning that the recipient does not have antibodies that react against the donor.
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Written 1/07
