What is living donation?
Living donation is when a living person donates an organ or part of an organ to a person in need of a transplant. Living kidney donation is possible because we can live a healthy life with one functioning kidney. Living liver donation is possible because the liver consists of two lobes, one of which can be donated to someone in need. Both lobes will regenerate to normal size and function generally within 6-12 weeks.
Why is living donation important?
Living donation offers another choice for transplant candidates, and reduces the number of people on the national transplant waiting list (from deceased donors). Even better, kidney and liver patients who are able to receive a living donor transplant can receive a good quality organ much sooner, often in less than a year.
The limited number of deceased donor organs cannot meet the growing need for lifesaving organ transplants. Living donation is one way we can give more people access to the lifesaving transplant they need. Other benefits of living donation include:
- The recipient can be transplanted while in better health and better able to tolerate the surgery.
- Living donor organs are often better quality and on average last longer than deceased donor organs.
- Kidney disease patients can avoid years of dialysis.
- The surgery can be scheduled at a time convenient for both the donor and the recipient.
- Many living donors refer to the experience as one of their most rewarding achievements.
Does the living donor need to know the person to whom they donate an organ?
No. A person may donate to a specific person they know or anonymously to someone in need. This would be a non-directed donation.
What is involved in the evaluation to be a living donor?
The evaluation is designed to protect both the donor and the recipient. It ensures that the donor is healthy enough for the surgery and is making an informed decision. A potential living donor undergoes both physical and psychosocial examinations. Testing can vary depending on the organ and donor’s age. In addition, routine health screens will need to be up to date before donation can occur. Learn more about living donation health screens from the American Society of Transplantation (AST).
What is paired kidney donation and living donation chains?
Sometimes a transplant candidate has someone who wants to donate a kidney to them, but tests reveal that the kidney would not be a good medical match. Paired donation, also called paired kidney exchange, gives that transplant candidate another option. In paired donation, two or more pairs of living kidney donors and the individuals they want to donate to are swapped to form a compatible medical match. For more detailed information, check with your transplant hospital or learn more about paired kidney donation from UNOS.org
Life and Health After Living Donation
Can living kidney donors live a healthy life with a single kidney?
Studies suggest that people can live a normal, healthy life with one kidney. Living kidney donors are carefully screened to ensure they are healthy before living donation can take place. They are encouraged to have regular checkups and follow a healthy lifestyle.
Can living liver donors live a healthy life with a portion of their liver removed?
Living-donor liver transplant is possible because of the liver’s ability to regenerate. A living liver donor can have a portion of their liver removed and it will regenerate or grow back within a few months after surgery. While recovery times may vary, most living liver donors are able to return to their pre-donation level of health within a few months after donating. Donors are required to follow-up with the transplant hospital for two years following both kidney and liver donation.
Does living organ donation shorten the donor’s life expectancy?
No, there is no evidence that living donation shortens a lifespan.
Are living kidney donors more likely to get kidney disease?
Living kidney donors are counseled about their individual risks associated with donation. The transplant team educates donors about the expected post-donation kidney function. In general, the risk of kidney disease does not exceed that of the general population with the same demographic profile.
Are living liver donors at more risk for liver disease?
Acute liver failure occurs in 0.1% of liver donors and usually occurs in the first three months after donation. After that your liver has grown back. However, you should continue to maintain healthy habits and follow up with your medical team to monitor your liver health.
Are living donors able to participate in sports or exercise?
A kidney donor should be able to return to regular activities and exercise about 4 to 6 weeks after surgery. For liver donors the time could be a few months. Check with your transplant hospital for more details.
Do living donors have to take medications for the rest of their lives?
Generally, prescriptions for pain and stool softeners will be necessary in the immediate post-operative period only.
What should a living donor expect after surgery?
Ordinarily, there will be some pain after surgery, which will diminish and can be controlled with pain medication. For kidney donors it will be about one week and for liver donors about 2 to 3 weeks. Donors should plan to have a caregiver after returning home from surgery for a short time period. Check with the transplant hospital for more details.
Will a living donor be in the hospital for an extended period of time after surgery?
A kidney donor will be hospitalized on average for 1 to 2 nights. A liver donor will be hospitalized on average for 4 to 7 nights. Liver donors may spend at least 1 night in the ICU for monitoring. A donor will have some follow-up appointments after hospital discharge.
Does a living donor have to follow a new diet plan following donation?
A donor should eat a healthy, well-balanced diet, but there are no dietary restrictions.
Can a living donor consume alcohol following donation?
Excessive alcohol use is always dangerous. For liver donors, alcohol abstinence should occur for one month prior to surgery and for three months following donation. No specific restrictions for kidney donors.
Should a living donor avoid pregnancy after donation?
A donor should wait to become pregnant until medically cleared after donation.
Will a living donor’s sex life be negatively affected by donation?
Donors may engage in sexual activity when they feel well enough to do so.
Living Donation Finances
Who pays for the medical expenses related to living donation?
The costs for the medical testing, surgery and post-operative care are covered by the transplant hospital or recipient’s health insurance. However, the living donor is responsible for the cost of routine health screens and treatment of any medical issues discovered during the evaluation. The cost of treatment of future issues that result from the donation, may be covered. Medical costs that are not covered include post-surgical routine health maintenance. Employed living donors should learn about their company’s paid sick leave, disability and the Family and Medical Leave Act (FMLA) policies if applicable. A transplant financial coordinator is available at each transplant hospital to answer questions.
Will the living donor have any out of pocket expenses?
Yes. It varies case by case and could include lost wages, travel expenses, childcare costs, etc. The National Organ Transplant Act allows for organ recipients to pay their living donors’ travel and housing in connection with the donation. The transplant hospital financial coordinator will check with the insurance company of the intended recipient as the policy may provide a travel benefit. There are organizations that provide financial resources to living donors for uncovered costs depending on need. Transplant hospitals can provide additional information about options.
- National Living Donor Assistance Center (NLDAC) Note that eligibility for financial assistance from NLDAC is based on the recipient’s household income which may not be more than 300% of the current Federal Poverty Guidelines.
Will a living donor have trouble getting health insurance or life insurance after they donate?
Being a living donor may affect the ability to get health or life insurance. The transplant team can provide details.
Other Living Donation Considerations
How risky is living donor surgery?The surgery to donate a kidney is generally safe, with a 3 in 10,000 risk of death. The risks for living liver donation surgery are slightly higher, dependent on the amount of liver donated. More information about living donation risks is available on the United Network for Organ Sharing (UNOS) website, TransplantLiving.org. As with any surgery, living-liver donation can include complications such as bleeding, infection, bile duct problems, and blood clots, etc. Complications occur in about 16% of cases. Living donors are carefully evaluated prior to a living-donor liver transplant to ensure that risk is minimized. The estimated mortality is about 0.5% (5/1000), depending on which lobe (part) of the liver is donated.
Can adults over age 50 donate?Yes, donors must be healthy and can donate primarily on a basis of health. Some transplant hospitals may have age restrictions.
Can members of the LGBTQ+ community be living donors?There are no restrictions based on a potential donor’s LGBTQ+ identification. All potential living donors undergo a thorough medical evaluation to determine if donation is safe.
Can people living with HIV be living donors?The HIV Organ Policy Equity Act (HOPE) Act provides donation and transplantation opportunities for people living with HIV with minimal additional testing at specific centers. Refer to the OPTN HOPE (HIV Organ Policy Equity) Act page for more information.
Are people with tattoos able to be living donors?All potential living donors undergo a thorough medical evaluation to determine if donation is safe for both the donor and recipient.
What happens if a living donor changes their mind?Being a living donor is completely voluntary. The donor can delay or stop the process at any time. Their reasons for choosing to not donate will remain confidential and will not be shared with the recipient or anyone else.
Do living donors ever share their experiences and what are some resources?Yes, 97% of living donors say they would donate again and are excited to share their experiences. Donate Life WELD (We Encourage Living Donation), a program of Donate Life America, provides a forum for living donors to share their stories with members of their community. To learn more about DL/WELD, contact DL/WELD coordinator. For stories from living donors, visit DonateLife.net.
How to Start the Living Donation Process
How would a potential living donor start the process if they want to donate to a specific person?
Contacting the transplant hospital of the person in need of the transplant is the first step. Many hospitals have a form on their website potential donors can submit to begin the process or they can call the transplant hospital and ask to speak with the living donor coordinator for the organ they wish to donate.
What if the intended living kidney donor and intended recipient are not a match?
Begin by talking to the transplant hospital where the intended recipient is listed to see if they participate in paired donation. The OPTN Kidney Paired Donation Program facilitates paired donation between transplant hospitals.
What if the intended living liver donor and intended recipient are not a match?
Living liver donors are carefully evaluated to ensure that they are the best medical match for the intended recipient. If the donor is not a match, he or she may be asked by the transplant hospital to become a donor for someone else on the waiting list. Many transplant hospitals offer resources to help patients on the waiting list find a suitable living donor.
What is the first step for a potential living donor who does not have a specific recipient in mind?
Please refer to the Organ Procurement and Transplantation Network (OPTN) member list of all U.S. transplant hospitals. You may also want to consider being part of a living kidney donor paired exchange or chain. (see above)
What if I am a patient in need of a transplant?
If you are not already on the national transplant waiting list, that would be the first step. Please see the list of transplant hospitals. Once you are on the national transplant waiting list, if your transplant team determines that living donation is an option for you, they can provide resources for identifying potential living donors.
What else can be donated while you are alive?
Although most people are familiar with blood and bone marrow donation, the field of living donation is ever evolving. Currently other things that can be donated include uterus, birth tissue and cord blood.
Is there anything that can be donated after childbirth?
Birth tissue and cord blood can be donated after childbirth and require a specific authorization.