Living Donor Kidney Transplant

Kidneys are the most common organs transplanted from a living donor. Transplant surgeons remove one entire kidney from a donor and transplant it to another person. Kidneys for transplant come from either living donors or deceased donors.

At the University of Maryland Medical Center, about one third of our kidney transplants are living donor transplants.

Deceased donor kidneys come from people who recently died from trauma, like brain hemorrhage or head trauma, or who were hospitalized and taken off life support. For deceased donor kidneys, time to transplant is crucial to ensure proper function.

Living donor kidneys come from someone who is on a kidney donor list or who agrees to donate a kidney to a relative, friend or even a total stranger. There is usually no "expiration date" for living donor kidneys, unless the kidney must be transported to the recipient.

Because living donor kidney transplant is crucial to keeping patients alive, we continually find new ways to make this life-saving surgery available to more people.

How You Can Help: Recipients with living donors get transplants faster and have better outcomes. Even if you cannot be the donor, you can play a valuable role by becoming a living donor transplant champion. Learn more about living donor champions.

Living Donor Kidney Transplant Benefits

If you need a kidney transplant, the advantages of living donor transplant include:

• Better outcomes: Patients who receive kidneys from living donors generally have significantly better long-term survival than those with kidneys from a deceased donor.
• Shorter wait times: Living donor kidney transplants dramatically reduce your wait time to days or weeks, compared to several years for a deceased-donor kidney.
• More donor options: Kidneys from unrelated living donors, such as spouses or friends, are as successful as those from close relatives.
• Expedited transplants: We offer expeditious transplants for all kidney donor pairs, including those with complicated testing needs or with polycystic kidney disease (PKD) who need simultaneous kidney and pancreas transplant surgery.

Who Can Be a Living Donor

While we urge everyone to consider kidney donation, guidelines for potential donors include:

• Donor age between 18 and early 70s
• Parent, adult child, sibling, or other relatives and friends
• Blood type compatible with the recipient. Alternatively, paired kidney exchange is an option for incompatible pairs
• Good overall health

You usually can't be a kidney donor if you have cancer, diabetes, kidney, heart or liver disease, sickle cell disease, HIV or hepatitis.

Living Donor Kidney Transplant Types

Different types of living donor kidney transplant include:

Directed Donation

The donor naming a specific recipient is the most common type of living donation. The donor may be:

• Biologically related, such as a parent, brother, sister or adult child
• Unrelated but has a personal or social connection, like being a friend or knowing a spouse or co-worker
• Unrelated and little connection, but learned of the recipient's need

Non-directed Donation

Here, the donor doesn't specifically name the recipient; the match is based on medical compatibility. Sometimes non-directed donors and recipients choose not to meet each other. However, they may meet if they both agree, and the transplant center policy permits it.

Paired Kidney Exchange (PKE)

If a transplant candidate has a donor whose kidney is not a good match, paired kidney exchange may be an option.

In this type, one recipient's donor gives a kidney to another recipient and in return receives the other recipient's donor's kidney.

Living Donor Kidney Evaluation

When you offer to donate a kidney, you will go through a careful evaluation process:

1. A transplant nurse coordinator will review your health information, help you schedule lab testing to ensure compatibility with your recipient, and discuss our paired kidney exchange program. Although donors and recipients sometimes have blood tests together, you don't have to travel at this point if you live outside Baltimore.
2. You will have a day of testing at our Baltimore hospital, and possibly a second day to check your heart health. If necessary, you can have testing in your community and send the results to us.
3. You will meet with a transplant surgeon, a transplant nephrologist and a nurse coordinator, who will explain the process of kidney donation and potential adverse effects and will answer all of your questions about kidney donation.
4. We will generally tell you in about a week if you are approved as a kidney donor.

Dedicated Living Kidney Donation Team

As a living donor, our living kidney donation team will work with you and the recipient to ensure comfort and confidentiality. We support the best interests of each donor.

Our specialized donor team includes a:

• Donor surgeon: A transplant donor surgeon will perform a complete physical evaluation to ensure you are healthy enough to be a donor. The surgeon also thoroughly explains the risks of kidney donation and can address your questions and concerns. After your operation, the donor surgeon meets with you during your recovery.
• Nephrologist: A transplant nephrologist will perform a medical evaluation and review all your test results to ensure that your kidneys are healthy and kidney donation will not put you at increased risk of kidney disease in the future. The nephrologist will explained all the potential medical effects of kidney donation and answer all your related questions.
• Nurse coordinator: An assigned nurse coordinator arranges all testing and evaluations for donors, communicates results, and provides education and support throughout the donation experience. Your donor nurse coordinator is available to answer your questions about testing, preparation for surgery, inpatient hospitalization and your needs after surgery. Meet our nurse transplant coordinators.
• Clinical social worker: Potential kidney donors meet with a clinical social worker who will answer questions as you consider donation. The social worker also works with you to complete the psychosocial assessment that is part of the evaluation.
• Financial coordinator: The recipient's insurance covers all costs for your evaluation and surgery. The financial coordinator meets with donors to coordinate all billing and provide correct billing information.

Minimally Invasive Kidney Donation Surgery

At the University of Maryland Medical Center, we use minimally invasive single-incision laparoscopic kidney removal for living kidney donors. We are the first hospital in Maryland and only the third hospital in the U.S. to offer this procedure and one of the most experience ones performing this procedure.

What to Expect After Kidney Donation

You will have a private room where family and friends can visit after your surgery. You may be up and walking the next day. If you and your recipient agree, you can visit together. You will be discharged from the hospital in 1 to 2 days.

You can lead an active, normal life with only one kidney. After recovering from surgery, you will be able to work, drive, exercise and participate in sports. Your living donor transplant coordinator will answer all of your questions throughout the process. During your recovery you can expect:

• Regaining kidney function – Your remaining kidney function increases over time about 50 percent, maintaining your health
• Follow-up care – You'll return in 1 to 2 weeks for a post-operative exam. After that, you will have exams 6 months, 1 year and 2 years after your surgery. If you live far from UMMS, you can have your doctor examine you and send lab results to us.
• Recovery – Donors' long-term results are generally excellent, and they usually have a quick recovery.
• Rare complications – In rare instances, some donors may experience kidney failure for reasons that would have been the same whether they had one or two kidneys. If that happens, donors rank higher on the transplant waiting list to ensure they receive a kidney transplant sooner.

Learn More About Living Donor Kidney Transplant

For additional information about our kidney transplant program or to speak to someone about becoming a living kidney donor, call 410-328-5408 or download our living kidney donor guide.