Living Donor Kidney Transplant

Kidneys for organ transplant may come from a living donor or a cadaver — a person who has died and whose family has given permission for his or her organs to be donated. At UCSF Benioff Children's Hospital, the majority of transplant organs are obtained from people who have died, but there is a shortage of organs.

Nationwide, there are more than 50,000 patients on the kidney transplant waiting list, with more added each day. Because of the shortage, patients die while on the waiting list or become too sick to undergo transplant.

Living kidney donor transplantation is an important alternative. Patients who receive a kidney from a living relative or friend need not wait for a kidney to become available, so they're less likely to die while waiting for an organ or to get too sick to undergo a transplant.

Living kidney donor transplantation is possible because we are born with two kidneys, and when one is removed, the remaining kidney grows slightly to provide adequate kidney function.

Surgeons around the world have performed living kidney donor transplants since the 1950s. UCSF surgeons have performed living donor transplants since 1963.

The initial costs for living donor surgery, hospitalization, diagnostic tests and evaluation are usually paid by the recipient's insurance. Travel and living expenses, however, are not covered. Insurance coverage will be discussed with potential donors during the evaluation process.

Evaluation

Any healthy person can donate a kidney safely. You do not need to be a blood relative of the recipient.

Donors do need to be in excellent health, well informed about transplantation and able to give informed consent. They also must understand the risks of this surgery and agree to comply with instructions for follow-up medical care.

A potential living donor meets with a transplant doctor and a transplant coordinator to discuss the possibility of organ donation. Tissue typing and other tests will be performed to determine the potential donor's suitability. In some families, several people are compatible donors. In other families, no relatives or friends who volunteer are suitable.

Procedure

In the past, most living donors had an open surgical procedure with a large incision to remove the kidney, which usually resulted in a two-month recovery period. A new procedure, called laparoscopic donor nephrectomy, uses very small incisions, a thin scope with a camera to view the inside of the body, and wand-like instruments to remove the kidney. Only left kidneys are removed with this procedure, due to considerations of blood vessel length.

Most laparoscopic nephrectomy patients need to stay at the hospital only two or three days after the surgery, compared to four or five days for a conventional open nephrectomy. In our experience, the laparascopic procedure is just as safe for both donor and recipient, and recovery is easier for the donor. Donors often are able to return to work as soon as three weeks after the procedure.

Any donor with suitable anatomy can have a laparoscopic nephrectomy. Since UCSF began performing laparoscopic nephrectomies in 1999, almost all of our living donors have been able to donate their kidneys using this approach.

The quality and function of kidneys that are transplanted this way are excellent.

The laparoscopic procedure will be described in detail in a consultation before the planned surgery date. The operation usually takes about three hours.

Recovery

Once the donor leaves the hospital, he or she will be seen for follow-up care in the transplant clinic. Donors from out of town should plan on staying in the area for a week after leaving the hospital.

Donors don't need medication or special diets once they recover from surgery. As with any major operation, there's a chance of complications, but kidney donors have the same life expectancy, general health, kidney function and activities as most other people. The kidney loss doesn't interfere with a woman's ability to have children. Potential donors whose jobs require extreme physical exertion need to discuss this with the transplant staff.

 

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Organ Transplant

Kidney Transplant Program
1825 Fourth St., Sixth Floor
San Francisco, CA 94158
Phone: (415) 353-8377
Toll-free: (800) 482-7389

Condition Information

Our Experts

Christopher E. Freise
Dr. Christopher E. Freise,
organ transplant surgeon