While it is important to talk about end-of-life decisions including organ donation, it is becoming more common to donate organs and partial organs while living. Kidneys are the most common organs donated by living donors. Other organs that can be donated include a lobe of a lung, partial liver, pancreas or intestine.
Although the decision to become a living donor involves careful consideration, being a living donor offers patients an alternative to waiting on the national transplant waiting list for an organ from a deceased donor.
To learn more, choose an option below:
- Who can be a living donor?
- Types of living donation
- Risks and recovery
Who can be a living donor?
While many people are willing to be living donors, not everyone has the qualities necessary to participate in living donation. Donors must be chosen carefully in order to avoid outcomes that are medically and psychologically unsatisfactory.
While the individual circumstances of each potential donor are discussed privately and tested to determine compatibility.
Individuals considered for living donation are usually between 18-60 years of age. Gender and race are not factors in determining a successful match.
Types of living donation
Although not all transplant centers perform all types, living donation has expanded to include many variations since the practice began in 1954, including:
- Related – Blood relatives of transplant candidates including brothers, sisters, parents, children (over 18 years of age), aunts, uncles, cousins, half brothers & sisters, nieces and nephews.
- Non-Related – Individuals emotionally close to, but not related by blood to transplant candidates, including spouses, in-law relatives, close friends, coworkers, neighbors or other acquaintances.
- Non-Directed – Individuals who are not related to or known by the recipient, but make their donation purely out of selfless motives. This type of donation is also referred to as anonymous, altruistic, altruistic stranger, and stranger-to-stranger living donation.
- Paired Donation – Consists of two kidney donor/recipient pairs whose blood types are not compatible. The two recipients trade donors so that each recipient can receive a kidney with a compatible blood type.
- Kidney Donor Waiting List Exchange – If a paired exchange cannot be found, living donors in certain areas of the country may be eligible for living kidney donor list exchange. In this type of exchange, a kidney donor who is not compatible with their intended recipient offers to donate to a stranger on the waiting list. In return, the intended recipient advances on the waiting list for a deceased donor kidney.
- Blood Type Incompatible – This type of donation allows candidates to receive a kidney from a living donor who has an incompatible blood type. To prevent immediate rejection of the kidney, recipients undergo plasmapheresis treatments before and after the transplant to remove harmful antibodies from the blood, as well as the removal of the spleen at the time of transplant.
- Positive Crossmatch – The positive crossmatch process is similar to the process used for ABO-incompatible living-donor kidney transplants, where patients can receive kidneys from living donors with blood types incompatible with their own. Similarly, treating patients with plasmapheresis also greatly reduces the chance of organ rejection in patients with elevated antibody levels. Positive crossmatch live donor kidney transplants are usually only performed if no other live donors (with a negative crossmatch) exist.
Risks and recovery
Although transplantation is highly successful, complications for the donor and recipient can arise.
However, living donation does not change life expectancy, and after recovery from the surgery, most donors go on to live happy, healthy and normal lives.
For living kidney donors, the remaining kidney will enlarge slightly to do the work that two healthy kidneys share. The liver has the ability to regenerate and regain full function. Lungs and pancreas do not regenerate, but donors usually have no problems with reduced function.
The usual recovery time after the surgery is short, and donors can generally resume their normal home and working lives within two to six weeks.
Be sure to talk to your doctor about what to expect.