Kidney Transplant (Living Related Donor)
A living-donor kidney transplant is the removal of a kidney from a living donor and placement into a recipient whose kidneys no longer function properly. Only one donated kidney is needed to replace two failed kidneys, which makes living-donor kidney transplant an alternative to deceased-donor kidney transplant.
About one-third of all kidney transplants performed in the U.S. are living-donor kidney transplants. The other two-thirds involve a kidney from a deceased donor.
Any healthy person can donate a kidney. When a living person donates a kidney the remaining kidney will enlarge slightly as it takes over the work of two kidneys. Donors do not need medication or special diets once they recover from surgery. As with any major operation, there is a chance of complications, but kidney donors have the same life expectancy, general health, and kidney function as most other people. The kidney loss does not interfere with a woman's ability to have children.
Potential Barriers to Living Donation
- Age < 18 years unless an emancipated minor
- Uncontrollable hypertension
- History of pulmonary embolism or recurrent thrombosis
- Bleeding disorders
- Uncontrollable psychiatric illness
- Morbid obesity
- Uncontrollable cardiovascular disease
- Conronic lung disease with impairment of oxygenation or ventilation
- History of melanoma
- History of metastatic cancer
- Bilateral or recurrent nephrolithiasis (kidney stones)
- Chronic Kidney Disease (CKD) stage 3 or less
- Proteinuria > 300 mg/d excluding postural proteinuria
- HIV infection
What you can expect
Living-donor kidney transplant usually involves a donated kidney from someone you know, such as a family member, friend or co-worker. Genetically related family members are most likely to be compatible living kidney donors.
A living kidney donor may also be someone you don't know, a nondirected living kidney donor.
Both you and your living kidney donor will be evaluated to determine if the donor's organ is a good match for you. In general, your blood and tissue types need to be compatible with the donor's.
But even if your donor isn't a match, in some cases a successful transplant may still be possible with additional medical treatment before and after transplant to desensitize your immune system and reduce the risk of rejection.
If your living kidney donor isn't compatible with you, your transplant center may offer you and your donor the chance to participate in the paired donation program. In paired organ donation, your donor gives a kidney to someone else whose is compatible. Then you receive a compatible kidney from that recipient's donor.
Once you've been matched with a living kidney donor, the kidney transplant procedure will be scheduled in advance. The kidney donation surgery (donor nephrectomy) and your transplant will occur on the same day.
Why it's done
Compared with deceased-donor kidney transplant, living-donor kidney transplant offers these benefits:
- Less time spent on a waiting list, which could prevent possible complications and deterioration of health
- Potential avoidance of dialysis if it has not been initiated
- Better short- and long-term survival rates
- A pre-scheduled transplant once your donor is approved versus an unscheduled, emergency transplant procedure with a deceased donor
- Living-donor kidneys almost always start working immediately after transplant compared with deceased-donor kidneys that can have delayed function
Risks of living-donor kidney transplant are similar to those of deceased-donor kidney transplant. They include risks associated with the surgery, organ rejection and side effects of anti-rejection medications.