Living Kidney Donor

The Pediatric Kidney Transplant Program at Cincinnati Children's works to identify kidney transplant donors.

All living donors must be healthy and have excellent kidney function.

Acceptable living donors are between 18 and 50 years of age and have blood and tissue types compatible with the recipient. Determining donor and recipient blood and tissue type is part of the pretransplant evaluation.

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 parent, step-parent or a family friend, could be matching donors.

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 antibodies against their tissue markers) pair up with other incompatible donors / recipients. Eventually, the kidneys are exchanged between the pairs. Cincinnati Children's Hospital Medical Center participates in such a program, The North American Paired Donation Network.

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 unneeded 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 in need of dialysis and 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.

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 three to four days.

Donor Recovery

The donor's recovery time depends on which type of surgical procedure they use to remove the kidneys but most donors are able to return to work within four to six 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.

Psychosocial Evaluation

The donor will meet with a living donor advocate 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.

The donor will be given a billing instruction letter at the start of the evaluation which gives directions to all of the providers along the way of his or her 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. Accordingly, the potential 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 living donor advocate can give the donor's information to apply to the National Living Donor Assistance Center.  For donors who qualify, this may be a source for help with travel, lodging and meal expenses related to the evaluation and 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 preop 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.

Last Updated 12/2012