Living donation occurs when a healthy person donates a kidney or part of the liver, lung, intestine, pancreas, bone marrow, or blood to another person.
Living donations are categorized in the following ways:
- Living Related Donation: The living donor is biologically related to the recipient, such as a parent, child, brother or sister.
- Living Unrelated Donation: The living donor is emotionally related to the recipient, such as a good friend, spouse, or in-law.
Non-directed or altruistic donation: These individuals donate to an anonymous candidate on the waiting list. Some donors may eventually meet the transplant candidates, but only if both parties agree.
Living donors are usually between 18 and 60 years of age and are often close relatives of the intended recipient. However, acceptable ages may vary by transplant center and the health of the donor candidate.
The prospective donor must have a compatible blood type, and in the case of kidney donation, tissue type, as determined by lab tests of the donor and recipient.
The donor candidate is carefully evaluated by lab tests, a physical examination, and a psychosocial examination to ensure that the candidate is healthy enough to donate and that he or she is making an informed decision. The decision about whether to accept the donor is then made by the health care team at the transplant center.
Please note: It is illegal to sell human organs for the purpose of transplantation. Federal law stipulates that no person may be paid and/or receive valuable consideration for donating an organ.
What organs can be donated?
The most common kinds of living donation are living kidney donation and living liver donation. Kidneys and livers are the organs most in need.
Types of Living Organ Donation
- Kidney (entire organ)
- Liver (segment)
Tested and successful:
- Lung (lobe)
- Intestine (portion)
- Pancreas (portion)
People can also become living donors by donating blood or bone marrow, and, in some instances, nerves or skin.
Positive Aspects of Living Organ Donation
Transplants performed from living donors have several positive aspects:
For the Recipient:
Quality of life: Transplants can greatly improve a recipient’s health and quality of life, allowing them to return to normal activities. They can spend more time with family and friends, be physically active, and pursue their interests.
Shorter waiting time: Due to the lack of organs available for transplant, patients on the national transplant waiting list often face a long wait (sometimes several years) before they are able to receive a transplant from a deceased donor. Patients who find a suitable living donor do not have to wait on the list.
Better results: Transplant candidates generally have better results when they receive organs from living donors as compared to organs from deceased donors. Often, transplant organs (called grafts) from living donors have greater longevity than those from deceased donors. Also, better genetic matches between living donors and candidates may lessen the risk of rejection.
Kidneys and Livers Functions Immediately: A kidney or liver from a living donor usually functions immediately in the recipient. (In uncommon cases, some kidneys from deceased donors do not work immediately, and as a result, the patient may require dialysis until the kidney starts to function.)
For the Living Donor:
Positive emotional experiences: The gift of an organ can save the life of a transplant candidate. The experience of providing this special gift to a person in need can serve as a positive aspect of the donation. Some donors have reported positive emotional experiences from their donation.
For Both the Recipient and the Living Donor:
Flexible time frame: Surgery can be scheduled at a time that is convenient for both the donor and recipient.
Removes a candidate from the list: A living donor removes a candidate from the national transplant waiting list, which is currently above 120,000 people. This allows the people on the waiting list who cannot find a living donor a better chance of receiving the gift of life from a deceased donor.
How does living donation affect the donor?
Living donation does not change life expectancy, and after recovery from the surgery, most donors go on to live happy, healthy, normal, and active lives.
For kidney donors, the usual recovery time after the surgery is short, and donors can generally resume their normal home and working lives within two to six weeks. Liver donors typically need a minimum of two months to resume their normal home and working lives, sometimes longer.
Although transplantation is highly successful, complications for the donor and recipient can arise. Be sure to talk to your doctor about what to expect.
Effects on the Body
For living kidney donors, the remaining kidney will enlarge slightly to do the work that two healthy kidneys share. The liver has the ability to regenerate and regain full function. Lungs and pancreas do not regenerate, but donors usually have no problems with reduced function.
Risks to the Donor
As with any other surgery, there are several short and long-term risks associated with living donation.
There has been no national systematic long-term data collection on the risks associated with living organ donation. However, there are some studies that are currently gathering such information. Based upon limited information that is currently available, overall risks are considered to be low. Risks can differ among donors and the type of organ.
Limited Long-Term Data about Living Donors
The Organ Procurement and Transplantation Network (OPTN) has limited long-term data available on how living donors do over time. Based on OPTN data from 1998 through 2007, of the 3,086 individuals who were living liver donors, at least four* have been listed for a liver transplant due to complications related to the donation surgery. Of the 59,075 individuals who were living kidney donors from 1998 to 2007, at least 11* have been listed for a kidney transplant. However, the medical problems that caused these kidney donors to be listed for transplant may or may not be connected to the donation.
*This total only captures data on transplant candidates who are known to the OPTN/UNOS to be previous donors.
Studies have shown that donating a kidney or part of the liver does not affect a woman’s ability to have children. However, it is important that you tell your doctors of your plans to have children. Each case is different, and your doctor may have additional recommendations given your medical history. A recent study from Toronto says that women who have donated a kidney are at higher risk of developing gestational hypertension or pre-eclampsia during pregnancies that follow the donation. The study suggests the increase in risk is not enormous (about a 6% increase), and in fact most women who have donated a kidney can safely carry a pregnancy to term. More information about the study can be found here.
Police, Fire, and Military Service
Some police and fire departments or branches of the military will not accept individuals with only one kidney. Be sure to talk to your superior if you are considering becoming a living donor.
We’d like to thank Emily Boynton for her help in researching and compiling this guide.