Living Kidney Donor Program

Overview of Loyola's Living Kidney Donor Program

As a world-class academic medical center, Loyola’s doctors perform and teach the latest surgical advancements. Our board-certified transplant surgeons are widely regarded and highly skilled in transplant surgery.

We offer minimally invasive surgical techniques to remove the donated kidney to improve pain after surgery, obtain better cosmetic results and most importantly, facilitate rapid recovery after major surgery.

Our surgeons are experts in Robotic DaVinci assisted nephrectomy, allowing highly technical surgery in the presence of barriers such as obesity, multiple arteries or difficult kidney anatomy.

Exceptional Evaluation, Treatment and Care for Living Kidney Donors

More than 100,000 people in the United States are currently on the waiting list for a kidney transplant, according to the United Network for Organ Sharing (UNOS), which maintains the list. While the wait time for a deceased-donor transplant can last several years, living kidney donation can dramatically reduce wait times to months and lead to better outcomes.

In general, living-donor kidney transplants have several advantages over deceased-donor kidney transplants:

• Kidney donors and recipients have more flexibility in scheduling their surgeries.
• Living-donor kidneys are available sooner, which can limit or possibly eliminate the need for dialysis for end-stage kidney disease patients.
• Living-donor kidneys often start to function immediately after transplant surgery compared to a deceased-donor kidney, which can take days or weeks to start functioning.
• Living-donor organs often come from a relative and may be a closer match.
• Short- and long-term survival rates are significantly better than with deceased-donor kidneys.
• The donated kidney usually spends less time outside of the body, which improves its viability.
• Incompatibility often can be worked out before the transplant by filtering the blood of the recipient or participating in a kidney exchange, such as with Loyola’s pay-it-forward program.

If you have made the decision to become a living donor, you likely have seen a loved one go through much suffering because of a serious condition — or you may have decided to donate to ease the suffering of an acquaintance or a stranger.

Your kidney donation is life-saving for a patient with end-stage kidney disease; and research shows that healthy people who donate a kidney are at no greater risk for kidney disease than any other person.

What the Kidneys Do

Most people are born with two kidneys, which remove waste material from the blood and body in the form of urine, control blood pressure and stimulate the production of red blood cells.

When one kidney is removed, the other adapts and can take on the additional work of the donated kidney.

Comprehensive Evaluation and Testing for Living Kidney Donors

Weighing the possibility of donating a kidney is a large decision, and we want to be sure that you are truly ready to donate. Discuss what you are feeling with your care team, family, friends, counselor or clergy.

There are various requirements to become a living kidney donor, starting with a questionnaire about your health. If there are no conditions that would prevent you from safely donating, you will have the option to move forward with initial blood tests.

If you are found to be a possible candidate for donation, you will proceed to a comprehensive medical evaluation. Your doctor will take a detailed personal and medical history and conduct a physical exam. You will be instructed on the transplant process and undergo testing, which may include:

• Blood tests
• Chest X-ray
• CT scan
• Psychosocial evaluation
• Urine test

As part of your evaluation, you will meet with a psychologist for an examination to ensure that you are completely prepared for making such an important decision. There are several factors you should consider prior to making a living kidney donation, such as how this will this affect your:

• Current and future health
• Emotional health
• Family
• Finances
• Life insurance status
• Physical health

Once all the testing is complete, your case will be presented to the review board and the final decision of donation eligibility will be communicated to you by your donor coordinator. The chosen kidney will also be decided in the meeting based on anatomy and function testing obtained.

Your care team is completely separate from the recipient’s team. Nothing you discuss with your living donor advocate or anything related to your medical condition is ever discussed with the recipient’s team.

It is important to know that you have the right to delay or stop the process at any time. You are free to change your mind about donation at any time. The only two categories for a living donor are eligible or ineligible. You can tell your living donor advocate in complete confidence your feelings about donation.

You will also meet with one of Loyola's financial coordinators. Usually, the recipient’s insurance company pays for the labs, evaluations, donor surgery, post-surgery care and clinical visits. These details will be confirmed during the appointment with your financial coordinator.

Patients are responsible for their own transportation, lodging and any lost wages from missed days at work. However, your living donor advocate (LDA) can help determine whether you are eligible for financial assistance.

Learn more in our kidney transplant frequently asked questions.

What to Expect with Living Kidney Donation

Before Living Kidney Donation Surgery

Kidney donation generally does not compromise the donor’s life expectancy, lifestyle or increase the risk of kidney failure.

Donors will have Loyola’s extensive network of primary care and specialty care specialists at their disposal, making it more convenient to receive care before and after donation surgery.

Once you have been approved as a donor, your care team will work with you and your kidney recipient to arrange the surgeries. This is usually scheduled weeks in advance and at a convenient time for the donor and recipient.

During Living Kidney Donation Surgery

In the operating room, you will receive general anesthesia and be set up for an IV. Surgery is done using minimally invasive technology to reduce pain, improve recovery time and get better cosmetic results. The procedure can be done laparoscopic or using the DaVinci robotic technology. Our transplant surgeons have expertise in both techniques.

During surgery, your surgeons will need to make a small incision to be able to safely remove the kidney without damaging it. They also need to make small keyhole incisions to insert a camera and instruments. The entire surgery is done inside the abdomen.

The DaVInci robotic system is a more advance technology than laparoscopic surgery and replicates the surgeon’s movements of the hands inside the body, facilitating visualization of tissues and allows more complex procedures to be done safely.

After Living Kidney Donation Surgery

In the recovery room, your nurses will give you pain medication to ease any discomfort you may experience. Medications to help with nausea that may occur after anesthesia and monitor your vitals closely. You are then transferred to the transplant floor for follow up care.

Minimally invasive surgery allows for early recovery and return tom normal life. We expect you to get out of bed to the chair or walk in the room the same evening of the surgery, we would give you light dinner and full breakfast. Most donors are feeling good to go home by lunch time the next day.

After surgery, you will have lifting restrictions for about six weeks and you should be able to return to most other activities four to six weeks after surgery. You will be given clearance to drive in about two weeks.

Living donors have post-surgery follow-up care for at least two years. Your medical team will help you with a smooth transition to your primary care doctor, who will be updated on your care every step of the way.

Learn more in our kidney transplant frequently asked questions.

What are the Risks with Living Kidney Donation?

Living kidney donation does involve surgery, and with any surgery there are risks. In the case of kidney surgery, these may include:

• Allergic reaction to anesthesia
• Blood clots
• Death
• Developing high blood pressure
• Hernia
• Increased protein levels in the urine
• Infection at incision site
• Nearby organ damage or failure
• Need for dialysis or transplant surgery
• Pain
• Pneumonia
• Potential need for blood transfusions

Your Loyola transplant team will guide you through the decision to donate, as well as the evaluation, surgery and recovery processes. Your clinicians will help you weigh the risks of surgery to determine if you can safely donate. If you have any questions or concerns, please call us today.

Frequently Asked Questions about Living Kidney Donation

How can I become a donor or encourage a friend to become a donor?

Your decision to be a living kidney donor can make an impact that will save and enhance countless lives. Please register to be a donor here.

If you are thinking of being an organ donor after your death, Loyola Medicine has partnered with Gift of Hope Organ & Tissue Donor Network as part of the Hospitals for Hope campaign. You can register to become an organ and tissue donor on the Gift of Hope's website.

Does the donor have to be hospitalized for evaluation?

All tests to evaluate a potential donor are done as an outpatient. For the donation surgery, you will be in the hospital for one night and two days.

What does the donor’s pre-evaluation entail?

The kidney donor evaluation is an extensive physical exam that includes laboratory tests to check not only kidney function, but also the health of all the other organs. This includes diagnostic tests to check the function of the potential donor’s heart and general overall health.

A psychosocial evaluation is also performed to ensure that the donor can manage the emotional stress of donating a kidney and to make certain that the donation is being made without any pressure from others.

Is there an age limit for living donors?

Kidney donors have to be a minimum age of 18 and of sound mind and judgment to make such an important decision. The upper age limit is generally 70 years of age but may be evaluated on a case-by-case basis.

Are there any restrictions resulting from kidney donation for living donors?

After your full recovery, there are no lifestyle or work restrictions.

How are kidneys selected when a kidney patient has several donors?

If a recipient has more than one willing donor and assuming they are all appropriate to donate, the transplant team will choose the donor with the best possible match to have the best results. The decision may look at multiple factors, including best match tissue typing and blood type, the size of the kidneys, and anatomy of the organ. The realtionship of the donor to the recipient is not a heavily weighted factor with family, friends, spouses and children all welcomed.

Altruistic donation matches transplant candidates with generous, selfless donors who would like to give a kidney to someone they don’t know.

Are living donors at greater risk for developing kidney disease later in life?

Research has shown that people who were healthy and donated a kidney are at no greater risk for developing kidney failure than the same population in the general public.

What is recovery like for donors?

It is different for every person. The nurses caring for you will encourage you to tell them about any pain you are having so they can ease your discomfort.

Your doctors will monitor you closely for the first 24 hours after surgery, and you will begin to feel better within the first day. You will be encouraged to get up, walk around and do some deep breathing and coughing to prevent complications from the anesthesia.

As a donor, how long will my hospital stay be, and when can I go back to work?

Most people go home the day after surgery. If you experience more pain than normal, you may be required to stay an extra day until your pain is under control. Our medical staff will send you home with pain medicine.

Going back to work depends on the type of work you do; most people regardless of occupation can resume normal activities within a few days. The time needed for a complete recovery in order to return to all prior activity is approximately four to six weeks.

What should donors expect on an emotional level?

This differs from person to person. Some people will feel very happy they were able to help someone in need of a life-saving organ.

Other people might feel slightly depressed even though they helped someone in an incredible way. Some will feel completely the same afterward.

The important point is that all of these emotions are completely normal feelings after donation. Everyone is unique in how they respond. Most organ donors report an overall positive response and experience.

Do living donors have to pay more for insurance after kidney donation?

In the past, there were occasions when some had to pay more for life insurance after donating a kidney — but not necessarily health insurance.

There also has been evidence that some health insurance companies attempted to charge patients higher premiums after donating a kidney; but under current healthcare laws, pre-existing conditions are no longer an issue.