Donation: Step-by-Step

What do I do if I feel pressured to donate?

If anyone tries to force you to donate, then the transplant hospital will not allow the donation to take place. No one should pressure you to donate. Talk to your independent living donor advocate at the transplant hospital if you feel any pressure.

What are my rights as a living donor?

You will have a separate transplant team from the recipient in order to protect your rights as a potential donor and so that the surgeon can avoid a conflict of interest.

You can talk to your Independent Donor Advocate if you have any concerns, doubts, or questions.

What happens if I decide not to donate?

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As soon as the transplant team decides that the potential transplant recipient is an eligible transplant candidate, then you can begin the process of living kidney donor evaluation.

Contact the recipient's transplant hospital to schedule an appointment to:

• Get evaluated.
• Learn about your eligibility to donate.

Which transplant hospital should I go to for evaluation?

If you live far away from your recipient's transplant hospital, the recipient's transplant hospital can refer you to a local hospital to start the testing.

Click here to find a transplant hopsital near you.

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Why do I need to get tested to be a living kidney donor?

The transplant hospital needs to make sure that you are eligible to donate.

You need to:

• Be healthy enough to donate.
• Be comfortable with your decision.
• Have no medical, surgical or psychological problems.
• Be a match with your recipient ideally.

These are some of the conditions that could disqualify potential donors:

• High Blood Pressure
• Diabetes
• Obesity
• Chronic Kidney Disease
• Mental Health Problems

What are the steps I need to take to get tested?

1. Get medical tests and exams. Types of tests and exams include: Blood tests Imaging tests (CT scan or MRI) Complete physical exam 2. Get a psychological evaluation to be sure that you do not have any mental health problems, are comfortable with your decision, and want to donate.

How long does it take to get tested and cleared to be a living kidney donor?

The time it takes to get tested varies by transplant hospital and donor motivation.

It can take on average a couple of weeks to a couple of months to do all of the tests.

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You are a match with the recipient when you both:

• Share the same blood type
• Have similar genetic background.

The better the match, the better the chances that the recipient will do well and not reject your kidney.

What if I am not a match?

You can still donate your kidney in some hospitals:

The transplant hospital can give medicine to the recipient and remove antibodies (plasmapheresis) from him/her to help the recipient's body accept your kidney. This is called desensitization.

Sensitization is having many antibodies in the blood. If a person is highly sensitized, his or her immune system will be very ready to attack the transplanted kidney, causing organ rejection. Transplants are generally not possible for patients who are highly sensitized, unless patients go through an innovative treatment process offered at some transplant hospitals that de-sensitizes patients.

Sensitization usually occurs because of pregnancy, blood transfusions, or a previous organ transplant.

You can take part in a paired exchange donation. As arranged by the transplant hospital, two or more donor-recipient incompatible pairs swap donors who are matches with the recipient of the other pair. This can occur when the donor and recipient do not have a compatible match.

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The cooling off period is an optional period of time, e.g., 1-2 weeks, between the potential donor's consent decision and the scheduled donor surgery. The cooling off period is used to protect donors' autonomous decision-making and reduce undue pressure to donate.

During the cooling off period, potential donors are expected to reflect upon the information learned about donation, their decision, obtain further information or opt out before going ahead with surgery.

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Like any other major surgery, donation surgery has risks to the life of the donor. You will be put under general anesthesia. The operation lasts about 2 to 4 hours.

How is living kidney donor surgery done?

There are two different types of surgery:

• Laparoscopic surgery is most commonly used at most U.S. transplant hospitals. People recover faster because the incision is small and less muscle is cut. The surgeon makes one small cut (7cm or 3 inches) on the lower belly and two small cuts under the rib cage (1/2 cm to 1 cm or 1/4 inch to 1/2 inch), and uses a video camera system to view the kidney and remove it.


• Open surgery takes the donor longer to recover and there is more pain because the incision is bigger, and more muscle is cut. The surgeon makes one large cut through several layers of muscle on the side or front of the belly to remove the kidney.

Which type of surgery will you get?

Your doctor determines the type of surgery patients will get on a case by case basis.

Talk to your transplant team for more information.

Who is a part of my transplant team?

Nephrologists are doctors who specialize in kidney care and treating kidney disease. Surgeons are doctors who will remove your kidney and will care for you immediately after your surgery. Psychologists are the doctors who specialize in mental and emotional health. Psychologists will evaluate you to determine if you are psychologically ready to donate.

Transplant coordinators/nurses are your main contact with the transplant team. They will answer your questions as you get ready for your donation, and will care for you after the operation.

Social workers will focus on your non-medical needs during the transplant process, such as transportation, housing, and financial, family or community support.

Financial counselors will help you understand your insurance plans and your financial responsibility. They will give you resources and advice about your finances both pre- and post-surgery.

Independent Donor Advocates make sure that your rights as a potential donor are respected. Transplant hospitals are required to have an Independent Donor Advocate. The Independent Donor Advocate serves to:

• Educate potential living donors.
• Help potential living donors get information
• Protect the interests of potential living donors.
• Advocate for the rights of potential living kidney donors.

Transplant nurses will prepare you for donation surgery and tell you about the risks of donating. Transplant nurses will also take care of you after surgery and monitor your health to prevent complications.

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How long will I have to stay in the hospital?

Most donors stay in the hospital for 1 to 7 days depending on the type of surgery. Laparoscopic surgery: takes 1-2 days after surgery for donors to be discharged home. Open surgery: takes at least 7 days for donors to be discharged home.

How big will the scar be?

The size of your scar depends on the type of surgery.

Laparoscopic surgery: two scars 1/4 inch to 1/2 inch in length and one scar 2-3 inches or 5-7 cm in length.

Open surgery: one scar 6-10 inches or 15-25 cm in length

Click here for pictures of donors' laparoscopic scars.

What is recovery like right after donating?

You should start drinking liquids the day of surgery.

You will be on antibiotic medication for 1 day.

It is expected that donors get up and walk the same day as the surgery.

The catheter in your bladder (Foley) will be removed the next day after surgery.

In the first two weeks after donating, you will be on pain medications (narcotics) and you may feel:

• Pain
• Discomfort at the wound site
• Fatigue
• Tired

Average time off work: 2-4 weeks depending on your job.

• If you work in an office or are sitting much of the day, you may return to work in 2 weeks.
• You are not allowed heavy lifting (e.g., 15 lbs. or more) for 4-8 weeks after surgery to avoid developing a hernia.
• If you work requires heavy lifting, you may return to work in 8-12 weeks.

Q:  How soon after donating could I drive my car?

A:  Transplant providers suggest that kidney donors wait at least 1-2 weeks post-surgery.  You can drive as soon as you are not taking any pain medicines that contain opioids which can affect your reflexes.

Q:  How soon after donating could I lift my child?

A:  Transplant providers suggest that living kidney donors avoid lifting more than 15 lbs. for 8-12 weeks to prevent hernias.

Q: How soon after donating could I walk my dog?

A: Transplant providers suggest that you can walk your dog as soon as you return home.

Q:  How soon after donating could I start exercising again?

A:  You should start walking the same day as the surgery and be as active as possible.  If the wound site is clean, dry, intact, and healing well, living kidney donors can start exercising again 2-3 weeks after surgery. Living kidney donors can gradually increase the intensity of the exercise if they are not uncomfortable or feel pain.

Q:  How soon after living kidney donation could I go back to playing soccer?

A:  Transplant providers suggest that living kidney donors wait at least 6-8 weeks after donating to start playing soccer again.

What is long-term recovery like?

The whole healing process takes about 6 months. On average, the skin at the wound site heals after 7-10 days. The wound site underneath the skin takes longer to heal. Everyone heals at their own rate.

It takes about a year to go back to your normal self.

What is follow-up care?

You are expected to return to the transplant hospital for follow-up care for 2 years after donating (at 1 week, 6 months, 1 year and 2 years) to make sure you are healthy and that you did not get any complications due to your donation.

You should go to routine clinic visits with your primary care doctor every year after donating.

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