In an ideal world, all patients with end-stage kidney disease would be able to receive a kidney transplant from a deceased donor. However, there are currently only enough organs from deceased donors available for about 13% of the more than 83,000 people on the national kidney transplant waiting list.
But there is an option: living donor kidney transplantation (LDKT).
Although LDKT does not replace traditional deceased donor kidney transplantation it may offer the possibility of kidney transplantation to an additional 40% to 50% of patients on the national kidney transplant waiting list.
The immediate benefits of LDKT are twofold. First, because living donor kidney transplantation is an elective procedure performed when the recipient is in the “best” condition, he or she avoids the continued physical deterioration that inevitably occurs while waiting for a suitable kidney replacement. If the transplant is performed before the start of dialysis, the outcomes are even better.
And second, by avoiding the use of a deceased donor kidney, LDKT helps to shorten the UNOS waiting list and allow another patient on that list to benefit from transplantation.
Becoming a living kidney donor is possible because while we have two kidneys, we actually need only one to lead a perfectly healthy life.
Frequently Asked Questions About Live Kidney Donation
A: Live donor kidney transplantation is a procedure in which a living donor gives one of his or her kidneys to a person in need of a kidney transplant.
A: Candidates, or recipients, are those individuals with kidney disease who have been accepted and listed as appropriate deceased donor kidney transplant recipients (recipients of kidneys from deceased donors).
A: Living kidney donors must meet certain criteria, such as having a compatible blood type and being between the ages of 18 and 65. They must also have no serious kidney problems or medical conditions such as diabetes, cancer or heart disease.
A: After initial screening blood work is received and reviewed, a potential donor is scheduled for a consult with a transplant nurse and surgeon. This consult involves a discussion of the procedure itself, as well as an opportunity for the donor to ask any questions.
A: Simultaneously, two separate surgical teams perform the kidney donor and recipient surgeries. As one team works on preparing the recipient for the kidney, the other is working on removing one of the donor’s kidneys.
A: Our family waiting room is staffed by a nurse liaison who will provide frequent updates to the families of the recipient and donor throughout the surgery.
A: The average donor will be in the hospital for 2 to 3 days.
A: There will be no changes to their diet, but they should drink at least two liters of water daily for the first month after surgery. They may resume sexual activities and are allowed to consume alcohol in moderation as soon as they receive clearance from their surgeon.
A: Organ Procurement and Transplantation Network (OPTN) requires donors to have follow-up appointments 2 weeks after surgery, then again at 6 months, 12 months, and 24 months. Lahey also recommends you get physical checkups every year after the 24-month follow-up appointment.
Kidney Transplant Evaluation Process at Lahey
Before we list you as a kidney transplant candidate, you’ll need to go through our evaluation process. You will be meeting with multiple transplant team members. This is to help us determine:
- The severity of your condition
- That you are healthy enough to undergo surgery
- That you meet our transplant guidelines
- That you have a support system to help you with recovery
- The best plan for you for transplant surgery and post-transplant care
Some of the tests you will have include:
- Cardiopulmonary tests, including an electrocardiogram (EKG), cardiac stress test, pulmonary function test, and a chest x-ray
- Imaging tests, including CT scans, abdominal and renal ultrasound, and vascular ultrasound
- Compatibility tests of your blood to determine which type of kidney donor you are most compatible with
- Preventive care testing such as age-appropriate mammography, PAP, and colonoscopy
Other tests as deemed necessary
The Evaluation Decision
Once your pre-transplant evaluation is complete, your information is presented to the multidisciplinary transplant committee. The decision to accept a candidate is made by consensus of the committee based on the results of testing and opinions provided by team members.
Possible outcomes include:
- Accepted for listing for kidney transplantation and placed on the list as an active candidate
- Accepted for listing for transplantation and placed on the list as an inactive candidate (pending clearance of outstanding issues that will be outlined for you)
- Defer for additional testing, based on your medical condition
- Determination that you are not an appropriate transplant candidate (if you are declined, our physician will talk to you about your options)
Within 10 business days after the committee meeting, a letter will be sent to you detailing the decision of the committee, including any recommendations and required follow-up.
Do You Have a Donor?
The question of whether you have a living kidney donor is one of the most important in the kidney transplant process. Having a donor will greatly improve your entire kidney transplant experience. We strongly encourage you to ask your family or friends to make the life-saving decision to donate. If you are uncomfortable asking someone to donate a kidney for you, please speak with your transplant coordinator or social worker. They will help you devise strategies for discussing the topic with your friends and family.
The benefits of having a live kidney donor include:
- Shorter time on the kidney waiting list
- The ability to get a new kidney before you need dialysis; studies show that this leads to longer-lasting transplants
- Better outcomes (longer lasting and better function)