Five Questions to Ask Yourself
Here are five questions to ask yourself before deciding to become a living organ donor:
Am I intellectually ready?
- Have you spoken with your primary care physician and researched information regarding living donations?
- Do you understand the risks involved in this major medical procedure?
Am I emotionally ready?
- Have you emotionally prepared yourself for living donation and do you fully understand the possibility that the procedure may not be successful or could even be harmful?
- Are you ready to live with less than your usual full system of organs?
- Are you prepared to find out that you may not be a match or be healthy enough to donate?
- Do you understand that the testing/evaluation process could potentially uncover health conditions that were unknown to you before you considered donation?
Am I physically ready?
- Are you in good physical shape so that you may be able to withstand a major surgery?
- Do you have a healthy organ to donate?
- Will your body be able to live with less than your full complement of organs?
Am I financially ready?
- Have you thought through all of your financial responsibilities? Financial responsibilities to think about while you are being tested, in the hospital for surgery, and away from work while you recover are: savings, work requirements, travel expenses, time off of work (paid time-off, vacation, sick days, short-term disability, etc.), follow-up care, lost wages, family, dependents, pets, future obligations, insurance, bills, monthly expenses, etc.
- Do you have insurance protection in the event that complications arise during or after your surgery?
Am I spiritually ready?
- Are you driven to donate by the right motives?
To learn of further considerations for becoming a living donor, please download the “Being Asked to Donate” questionnaire from Transplant Living and the United Network for Organ Sharing.
Potential donors should talk with their employer, health insurance provider, transplant team, and hospital about lost wages, time off, and financial/insurance issues. The transplant center will have a social worker and/or financial counselor who can advise potential donors about their options, along with what expenses will be incurred by the recipient’s insurance, the donor, or the hospital.
Who pays for living donation?
Generally, the recipient’s Medicare or private health insurance will pay for the following of the donor (if the donation is to a family member or friend):
- Evaluation to determine if the person is a good candidate for living donation
- Donation surgery
- Post-operative care
The following expenses are usually not paid for by either the recipient or the donor’s insurance:
- Lost wages during the donor’s recovery. (Depending on your state, donors may be eligible for sick leave, state disability, and the Family and Medical Leave Act (FMLA).
- Travel expenses – Some transplant hospitals offer free or low-cost hospitality houses for the donor, recipient, and family.
- Expenses for treatment of unrelated conditions that are discovered during the evaluation process
- Some follow-up expenses may also not be covered, so it’s important to discuss these matters with the transplant center, the recipient, and your insurance company
Can I be paid for donating an organ?
No. Payment for organ donation is illegal under the National Organ Transplant Act of 1984 (NOTA).
How will donating affect my health and life insurance?
Some studies have indicated that a small percentage of donors reported some difficulty with their insurability. All donors are strongly encouraged to check with their insurance providers to verify their policy and, if necessary, consult with a lawyer who is knowledgeable about insurance law.
Is there any assistance available for lost wages, travel, and lodging?
The majority of living donors are not reimbursed for lost wages, travel, and lodging. Make sure to discuss your options with your employer or HR representative.
The National Living Donor Assistance Center (NLDAC) offers a program intended to provide reimbursement only in those circumstances when payment cannot reasonably be covered by other sources. The NLDAC may be able to provide reimbursement for lodging, travel, meals, and other non-medical expenses incurred during the entire donation process. For more information, please visit http://livingdonorassistance.org/.
How long will the donor be in the hospital and out of work?
Normally, donors do not have to stay in the hospital as long as recipients. An average stay in the hospital is 3-7 days for kidney donation and up to one week for liver donation. (The first day is for surgery and the rest for recovery.) It is best to take a couple of days off of work before the surgery for travel and pre-surgery testing and preparations.
When a donor is released from the hospital, he or she will need 4-6 weeks for full recovery. During this time, it is best to remain healthy by eating nourishing foods and resting as much as possible.
A donor may be able to go back to work within a week or two of the surgery, but he or she must remember to take things slowly and allow rest and time for recovery.
Risks to the Donor
Living donation surgery involves the same level of risk for the donor as any other major surgery. The majority of complications following surgery are not severe, but may cause a longer hospitalization. The risks associated with surgery and donation should be thoroughly discussed with your transplant team.
Please note that there has been no national systematic long-term data collected on the risks of becoming a living donor. Based upon the limited information currently available, overall risks are considered to be low. Risks can differ among donors and according to the type of organ donation.
Here are some short and long term risks potential donors should think about:
Possible Surgical Complications
Surgical complications can include pain, infection, blood loss, blood clots, allergic reactions to anesthesia, pneumonia, injury to surrounding tissue or other organs, and even death.
- Kidney: Some possible long-term risks of donating a kidney may include high blood pressure (hypertension); large amount of protein in the urine; hernia; organ impairment or failure that leads to the need for dialysis or transplantation; and death.
- Liver: Some possible long-term risks associated with donating a lobe of the liver may include wound infections; hernia; abdominal bleeding; bile leakage; narrowing of the bile duct; intestinal problems including blockages and tears; organ impairment or failure that leads to the need for transplantation; and death.
It is important to discuss these risks with the transplant team, the transplant candidate, and your family before making the decision whether to donate.
Though it is immensely important to thoroughly consider the above risks, remember to also consider the positive aspects of living donation.
Questions to Ask Your Transplant Center
Because there is limited long-term data on the risks of becoming a living donor, potential living donors should research the transplant center and be fully-informed about the center’s policies, experience, and statistics. Here are questions potential living donor should ask adapted from a Chicago Tribune article dated July 31, 2011:
- Do you have written information about living donation, including the hospital’s policies?
- What health problems would rule me out? And what tests will be done to evaluate me medically?
- Which surgeon will remove my kidney/liver? When will I meet with him or her?
- How many living donor procedures does the surgeon perform every year?
- What is the complication rate, and what post–surgical complications has the transplant center and/or the surgeon experienced? How many donors, if any, have died?
- How many of the transplant center’s recipients have a five-year graft survival, how many for 20 years, and what is the patient survival rate?
- Will I have an independent donor advocate? What are that person’s qualifications? And how will that person look out for me?
- Will a transplant staffer be available to assist me and answer questions after I leave the hospital? Are there any post-donation services available?
- How will the center handle any complications that I might have? And who pays for it?
- What are the transplant center’s follow-up plans?