What to expect before, during, and after kidney donation

The kidneys are two bean-shaped organs whose primary function is to filter blood and remove waste from the body. Kidneys are located on either side of the spine, just below the ribcage, and help produce red blood cells, play an important role in controlling blood pressure, and contain water, electrolytes, and other substances to maintain balance in the body so that cells function properly. It also helps regulate substances such as minerals. function. Humans have two kidneys, but only one kidney is enough for a normal life. This is one reason why kidneys are the most common transplant organ from living donors. In 2023, Over 6,000 living donors A person who has donated a kidney for transplant in the U.S. It is considered a safe procedure with a low risk of complications and a high success rate for organ recipients.

“Kidney donation is a wonderful gift from one person to another and can be life-changing for both donor and recipient,” said Dr. Froethardt, a transplant surgeon and professor of kidney and medical science at the Froetert and Medical College of Wisconsin. said Ty Dunn, MD, surgical director of the pancreas transplant program and MCW faculty member. “Making the living donor experience as perfect as possible is a huge burden for us because, unlike other surgeries, the goal of this surgery is to make the donor healthier or better. They are giving the gift of life to someone else.”

Become a living kidney donor

Living kidney donors must be at least 18 years old and in good overall health. The chance of being approved as a living kidney donor is approximately 1 in 4.

Certain medical conditions or circumstances that disqualify you from becoming a living donor include:

• uncontrolled high blood pressure
• Diabetes
• active cancer
• Evidence of forced or illegal financial transactions
• mental incompetence
• Conditions judged by medical staff to make the donor unfit to donate

The first step in considering kidney donation is an evaluation. The evaluation process is how the transplant team gets to know the potential donor and their medical and surgical history, and exchanges information about the donor from the perspective of the nephrologist (kidney specialist), donor surgeon, social worker, and dietician. Other team members involved in the evaluation include a pharmacist and an independent living donor advocate. Diagnostic testing for the evaluation includes blood and urine tests, as well as tests such as chest x-rays, electrocardiograms, and CT scans to evaluate the kidneys. The evaluation of a living donor is completed within a full appointment time at the clinic. All testing costs are paid for by the potential recipient's insurance.

“This assessment ensures that donors can donate safely and continue to live healthy lives for the foreseeable future,” Dr. Dunn said. “Our team is experienced in making complex donation decisions and provides individualized counseling. We consider each person’s unique situation, balance risks and benefits, and make informed decisions. It gives people the ability to make informed decisions.”

Nearly one-third of living kidney donors are not matched with their intended recipient, but participating in a kidney exchange program can make a living kidney transplant a reality. This provides the best long-term outcomes for recipients and significantly reduces the time recipients wait for deceased donor transplants.

Preparation for living kidney donor surgery

Once a living donor is medically approved, the timeline for surgery varies widely depending on the recipient's circumstances. In some cases, even if the donor and recipient are a good match; National Kidney Registry Pair Exchange. This allows the donor to schedule the surgery at a time that is convenient for them. It also takes advantage of better matching opportunities and prioritizes living kidney donors when recipients are ready for transplantation.

of National Kidney Registry offers specific programs This includes reimbursement for out-of-pocket expenses such as travel, lodging, dependent care, and lost wages, reducing financial disincentives for living kidney donors. For altruistic kidney donors (those who do not currently have a designated recipient), the Family Voucher Program allows donors to name up to five individuals. If any of these individuals were in need of a kidney, they would be given priority for living kidney donation. Donors who donate through the National Kidney Registry have never required a transplant of their own, but in the unlikely event that a living donor does need a kidney transplant of their own at some point in their life, the exchange program can also We will provide it as a top priority.

In Wisconsin, living organ donors can receive a state tax credit of up to $10,000 for unpaid expenses related to organ donation. Organ donation is also covered by the Family and Medical Leave Act (FMLA).

living kidney donor surgery

The surgical procedure to remove a healthy kidney from a living donor is called donor nephrectomy. This procedure will be covered by the recipient's insurance. The transplant team at Froedtert Hospital has extensive experience with complex living donor cases and offers a minimally invasive approach to bilateral kidney donation, including kidneys with multiple vessels and other complex features. To do. Nephrectomy is performed laparoscopically or robotically using instruments and a camera passed through small incisions. This has the advantage of faster recovery and minimal scarring. The nephrectomy incision is approximately 3 inches long and is placed in the lower abdomen, above the pubic hair, or on the left or right side of the abdomen, depending on the kidney being donated. Robotic technology allows for extremely precise precision and may also reduce pain.

Kidney donations are usually scheduled 4 to 6 weeks in advance. The week before, the living donor will come to the hospital for pre-surgical testing. The donor fasts on the morning of the surgery. He won't eat or drink anything (other than water) for 8 hours before the surgery. The surgery usually lasts two to three hours, after which the donor spends the night in the hospital. During the hospital stay, her team of care ensures that the donor achieves all important post-operative milestones. This means that the pain is well controlled, there are no signs of bleeding, and there is no difficulty in drinking, urinating, or walking. Patients are usually discharged from the hospital one day after surgery and continue their recovery at home. It is normal to have some pain or discomfort at first, but you can usually stop taking painkillers after a few days.

Most kidney donors do not experience complications after surgery. Froedtert Hospital's kidney transplant program consistently provides excellent outcomes that meet or exceed national standards.

“While complications can occur, there is a 95% chance that donor nephrectomy and recovery will go as planned,” Dr. Dunn said.

People with desk jobs can usually return to work in three weeks, while people with heavy-duty jobs may be out of work for up to three months. During her first 6 weeks after donation, she must not lift anything heavier than 10 pounds.

“The incision is small, but it's a major internal surgery,” Dr. Dunn said. “As the donor is a healthy person, he is not used to feeling tired or unwell. It is important that he is kind to himself and takes time to heal properly.”

Donors come to the clinic approximately three weeks after donation. They will have laboratory follow-ups at six months and at one and two years to record the health of their kidneys after donation. These visits are covered by the transplant recipient's insurance.

Life after donating a kidney

After donating a kidney, the body adapts and functions well with one kidney. The remaining kidney adjusts to accept the extra blood flow, so once it has healed, the donor will have about 70% of its original kidney function instead of half. Studies show that living kidney donors have a life expectancy that is similar to or longer than non-donors. This is because the living donor evaluation process selects those who are in above average health.
“The most important advice we give to living donors is to continue to maintain a healthy lifestyle,” says Froetert & MCW Adult Kidney and Pancreas Transplant Program Medical Director and MCW faculty member. says Bezier Thomas, MD. “Staying active and eating a healthy diet are the best ways to prevent excessive weight gain. Being overweight or obese increases your risk of diabetes and high blood pressure, which are known risk factors for kidney disease. ”

Living donors must also:

• Establishing a relationship with a primary care provider
• Continue to receive regular health checkups
• Avoid certain activities that can cause trauma to your remaining kidney, such as high contact sports such as rugby or boxing.
• Avoid smoking, excessive alcohol, and illegal drugs
• Always identify yourself as a kidney donor when prescribed medicines and carefully follow administration instructions.
• Talk to your doctor before taking over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs), which can affect kidney function.

“Our team is very experienced with living donor surgeries and has performed many of these surgeries,” Dr. Thomas said. “We are always available as a resource for living donors. They have the freedom to contact us as needed and we provide strong support and personalized attention.”