The best option for a patient waiting for a kidney transplant is to receive one from a living donor. At Ohio State’s Wexner Medical Center, we perform approximately 100 living donor transplants each year.
Patients with end-stage kidney disease have three options for treatment: dialysis, a kidney transplant from a deceased donor or a kidney transplant from a living donor.
Dialysis is only a temporary solution. Treatment schedules are time-consuming, as frequent as three times each week for four hours each session. While a patient can remain on dialysis for many years, it is not a cure for kidney disease. In fact, ten percent of patients on dialysis die each year while awaiting a kidney transplant. For some groups, such as elderly patients and patients with diabetes, there is an even greater risk.
The best option for a patient waiting for a kidney is to receive one from a living donor:
- Wait times for patients with living kidney donors are reduced from years to months, potentially avoiding dialysis
- Transplant recipients have better outcomes with kidneys from living donors
- Kidneys transplanted from living donors may last nearly twice as long as kidneys from deceased donors
About half of the transplants performed at Ohio State are performed with kidneys from living donors. Often living donors are family members, but a growing number are friends or co-workers. There are also people who choose to donate a kidney without having a specific recipient in mind. These extraordinary people are called non-directed or altruistic donors.
Candidates for donation
Your decision to become a living donor should be voluntary and free from internal or family pressure.
To qualify as a living kidney donor:
- You must be in good overall physical and mental health
- You must be free from uncontrolled high blood pressure, diabetes, cancer, HIV/AIDS, hepatitis, kidney disease and heart disease
- Gender and race do not matter
- Individuals considered for living donation are typically between the ages of 18 and 65
- A matching blood type is not a requirement for living kidney donation. Through Kidney Paired Donation (KPD), it is possible to donate with mismatched blood or tissue
The decision to become a living donor is a voluntary one, and the donor may change his or her mind at any time during the process. The donor’s decision and reasons are kept confidential.
Type directly into the form, then print and mail or fax to:
The Ohio State University Wexner Medical Center
Comprehensive Transplant Center
300 W. 10th Ave., 11th Floor
Columbus, OH 43210
The donor undergoes a medical history review and a complete physical examination. A psychological evaluation may be used to provide information, emotional support and assess motivation.
All prospective living donors meet with our living donor advocate to discuss the candidate’s decision to become a donor. The living donor advocate provides unbiased, confidential support, discusses your willingness to donate and assesses your understanding of informed consent.
Here’s what you can expect during your evaluation process:
- You will need to provide a copy of your blood type or have blood drawn to confirm blood type
- 24-hour blood pressure monitoring
- Female donors will need to provide a copy of their last Pap test result, breast exam and mammogram report. If your Pap test or mammogram is more than a year old, you should schedule an appointment for new exams
- You may need to complete a glucose tolerance test (GTT) if requested by the Pre-Transplant Office
- Blood collection for comprehensive tests and screening for communicable disease
- 24-hour urine collection (this will be performed twice)
- Chest x-ray and EKG
- CT angiogram of kidneys
- Final pre-donation laboratory studies (done seven to 10 days before surgery)
- Full day at Transplant Clinic for education, meeting with transplant coordinator, psychosocial evaluation, surgical and medical evaluations and completion of tests
All donation and transplant surgeries are done at Ohio State’s Wexner Medical Center by our transplant team. If our transplant team clears you as a donor and your recipient has been identified, the surgery will be scheduled withing a few weeks.
The day of your donation surgery, you will be asked to check in to the hospital, usually in the early morning.
When you arrive, you will be admitted into the hospital and taken to the pre-operation area. Once you are comfortable, the doctors and nurses will conduct a final examination. You can expect to have blood drawn and an IV placed in your arm. These final health checks help our transplant staff to know that you are in excellent health for donation. You will meet with your transplant surgeon prior to being taken into the operating room. This is also a good time for you to ask any last minute questions, and to openly talk about any concerns you may have before surgery.
Most donor surgeries are scheduled for early morning. To prepare you for surgery, you will be taken to a pre-surgical area and given medicine to help you relax. When the transplant team is ready, you will be taken into surgery. Your recipient will follow you to surgery a short time later and be placed in an adjacent operating room. If you are able to have laparoscopic surgery, you can expect the procedure to last about three hours. Once the kidney you are donating is removed, it will be placed into the recipient's body. You will then be taken to the surgical recovery room where you can expect to stay for one to two hours.
After your observation time in the recovery room, you will be taken back to your room in the transplant unit where family and friends are welcome to visit. While in your room, you will be closely monitored by our transplant team to ensure you are recovering well, have little stomach upset and are able to eat, use the bathroom and pass gas and are free from infection.
After Donation Surgery
Care After Donation
Every person reacts differently to surgery, and while some may be up and about the following week, it may take some a few more weeks to return to normal routines. Expect to restart all normal activities within two to three weeks of surgery. To prevent wound healing problems, do not lift objects over five to 10 pounds for at least six weeks after surgery.
During your recovery at home, we encourage you to contact our transplant team if you have questions or concerns about your progress.
After donation surgery, your continued good health is our main concern. It is required that you schedule and keep the follow-up appointments with Ohio State's Transplant Center. Appointments will need to be scheduled for:
- Six weeks after surgery
- Six months after surgery
- One year after surgery
- Two years after surgery
After two years, we encourage you to visit your primary care physician for annual checkups.
Frequently Asked Questions
Frequently asked questions
Are there health concerns with donating a kidney?
Living kidney donation surgery is considered a relatively safe procedure, but it is still a major surgery with the potential for complications. Typically, the hospital stay for a living kidney donor is three to four days.
If you are a donor who is a woman who wishes to have children, kidney donation does not affect completion of a safe pregnancy. However, it is recommended that donors wait at least six months before becoming pregnant.Life expectancy after donation is the same as that of people with two kidneys. A single kidney is able to meet the body's needs very well. It actually enlarges to do the work formerly shared by both kidneys.
What is recovery like?
The operation may be done as laparoscopic surgery, which involves a smaller incision, requires a shorter hospital stay and allows for a faster recovery. Most donors are eating and drinking the day after surgery and able to go home on the second or third day after surgery. About a week after surgery, donors generally report feeling tired but ready to go about normal activities. For the first six weeks, donors are restricted from lifting anything over five to 10 pounds. After that six-week period, all normal life activities can be resumed.
Who pays for the donation surgery?
Some donors may be eligible to receive financial assistance for donation expenses like transportation, parking and hotels. There is no financial assistance available for lost wages. A new Ohio law gives state employees paid time off work for donating.
What if my religion doesn’t approve of organ donation?
All major religions practiced in the United States support organ and tissue donation and consider it a generous act of caring. Speak with your religious leader about donation.
Paired Kidney Donation
Kidney Paired Donation
Sometimes, a person may agree to donate a kidney to a recipient, but his or her blood or tissue type does not match their recipient. Ohio State’s Comprehensive Transplant Center can help match such a donor/recipient pair with another donor/recipient pair through a process called Kidney Paired Donation (KPD).
For example, if the recipient from one pair is a match with the donor from another pair and vice versa, our Transplant Center can arrange the exchange through two simultaneous transplants. This allows the two recipients to receive organs from two people who were willing to donate, even though the original pairings were incompatible or mismatched.
Both donor and recipient candidates are carefully evaluated and tested medically and psychosocially to ensure that the benefits outweigh the risks. It is important for both surgeries to be scheduled for the same time, in case either donor changes their mind at the time of surgery. Though the surgeries take place at the same time, they can occur at different hospitals and even in different time zones.
Paired donation can also involve multiple donors and recipients. In September 2011, Ohio State achieved national recognition with a six-way paired kidney transplant, coordinating the in-house transplantation of six kidneys in a domino-effect surgical process.
Ohio State has an internal paired donation program in addition to working with national donor exchange registries to share information among hospitals to find matches for pairs of donors and recipients who are not matches. These types of paired exchanges will hopefully have a positive impact on the waiting list for kidney transplants.
Your doctor will help you decide if a paired kidney donation is a good solution for your donation.