What to consider before donating a kidney

What is living donation?

Living donation is a type of kidney transplant where a living person donates one of their two healthy kidneys to a person living with kidney disease. A living donor is the person who donates their healthy kidney. 

There are two types of living donation:

• Directed donation is when the living donor chooses the specific person with kidney disease who they want to donate their kidney to, such as a family member or friend.
• Non-directed donation is when the living donor does not have a specific person they will donate their kidney to. Instead, they donate their kidney to a stranger, such as through a paired kidney exchange program.

Who can donate a kidney?

To be a living kidney donor, you must:

• Be age 18 or older
• Have two healthy, working kidneys
• Be healthy enough to donate

How do I know if I am healthy enough to donate a kidney?

You will need to have a full health evaluation at the transplant center. You will meet with many members of the donor evaluation team. This team is specially assigned to work with you as a possible living donor and includes members similar to those on the transplant team. The evaluation will help your donor evaluation team decide if you are ready and healthy enough to be a living kidney donor.

As part of the evaluation, you will have many tests and exams, such as:

• Blood tests, such as to learn your blood and tissue types
• Urine tests
• Heart and lung tests
• Blood pressure check
• A spiral CT (computed tomography) scan or other imaging of your kidneys
• Colonoscopy to test for colon cancer if you are older than 50
• Prostate exam if you are a man
• Mammogram (test for breast cancer) and Pap smear (test for cervical cancer) if you are a woman

You can get all of these tests at a time that fits your schedule, without having to stay overnight in a hospital. 

You will also talk with a social worker. They will ask questions to make sure that you are mentally and emotionally ready to donate a kidney and that you have a support system to help you after the donation surgery.

If the donor evaluation team decides that you are healthy and you are a good match for the person getting your kidney, you may be approved to donate your kidney.

Who is on the donor evaluation team?

The donor evaluation team usually includes these team members:

• Social workers who review your social support system and finances and help you with any challenges, such as emotions, physical side effects or finances
• Dietitians who review your eating habits and activity level and can help create a plan to make healthy choices before and after donation surgery
• Transplant surgeons who do the donation surgery
• Doctors who have special training in a certain area of medicine such as the heart, kidney or liver. They help make sure you are healthy enough for surgery.
• Living donor coordinators who help organize your evaluation, prepare you for surgery and help coordinate follow-up care after surgery
• A living donor advocate who will make sure your rights are protected and that your choice to donate is voluntary

What may prevent me from donating a kidney?

There are some health conditions that may prevent you from donating a kidney, including:

• Heart, lung or blood vessel diseases
• High blood pressure, in most cases
• Kidney disease
• Diabetes
• Cancer, except for certain skin cancers
• Serious mental health conditions
• Certain infections, such as HIV
• Drug or alcohol use disorder
• Being very overweight (obese)

Can I donate a kidney if I drink alcohol?

Talk with your donor evaluation team to know if you can donate. In most cases:

• If you drink alcohol in moderation (up to one drink a day for a woman and up to two drinks a day for a man), you can likely move forward with donating a kidney.
• If you have issues with alcohol misuse, you may not be able to donate a kidney. Drinking too much alcohol can affect your overall health.

What are the possible benefits of donating a kidney?

Some of the possible benefits of donating a kidney are to:

• Help the recipient (the person who gets your kidney) live a longer, healthier life
• Save the life of another person
• Better understand your own health and health problems through the in-depth evaluation

What are the possible risks of donating a kidney?

When donating a kidney, there are possible physical, emotional and financial risks. The donor evaluation team will review the possible risks with you. They will not let you donate if you have a high risk. 

Physical risks 

There are risks to any surgery. Possible risks from surgery include:

• Pain at the surgery site
• Bloating
• Feeling weak and tired 
• Bleeding and blood clots
• Problems from being put to sleep, such as pneumonia (lung infection)
• Blocked bowel (being unable to pass stool, or poop)
• Infection 
• A scar from the surgery
• Feeling sick to your stomach

Emotional risks

After surgery, some people who donate a kidney may have:

• Anxiety or feel guilty if the kidney they donated isn't working well
• Stress
• Depression
• Fear

Talk with your donor evaluation team during evaluation and after donation for help coping with your feelings.

Financial risks

Medicare, Medicaid or the kidney recipient's insurance will cover the medical costs of donating a kidney. But most insurance companies do not cover:

• Time off from work
• Childcare
• Travel, parking and gas during the donation process
• Hotel costs during the donation process
• Meals

There may be programs to help with the costs that insurance will not cover. Talk with your donor evaluation team to learn more.

Donation can sometimes change your ability to get or afford health, disability or life insurance. Learn more about disability insurance and government help to pay for the donation process.

You may also have issues getting work in military service, law enforcement, aviation and fire departments because they may not accept people with only one kidney.

After I donate a kidney, will I have any side effects or health problems?

After you recover from the donation surgery, you should feel and be well. You can live with just one healthy kidney. Your remaining kidney will be able to do most of the work of both of your kidneys. 

It is rare to have long-term physical problems from donating a kidney. But people with one kidney may have a higher chance of high blood pressure, which doctors may treat with medicine.

What is kidney donation surgery like?

Most kidney transplant surgeries are done laparoscopically. A laparoscopic surgery is a type of surgery that uses very small cuts on the body and a laparoscope, which is a thin, lighted tube used to see inside the body. In kidney donor surgery, the surgeon makes small cuts (only a few inches long) on the donor's stomach and removes the kidney. 

The surgery takes two to three hours and the donor usually recovers in the hospital for one to three days.

Questions to ask yourself before donating a kidney

You may find it helpful to ask yourself these questions before you decide:

• Why do I want to donate my kidney to someone else?
• What other questions do I have about the donation process or the risks and benefits?
• Am I ready to deal with any physical, emotional and financial problems during and after donation?
• What will happen if I have unexpected problems after surgery?
• Who can I rely on for support during surgery and recovery?
• How will I feel if my donated kidney does not work? Will it affect my relationship with the person who got my kidney?
• Will I be changing my job in the near future? If so, how would donation affect my ability to get a job or life insurance?

Your transplant center has a social worker who can help you make your decision. You may also want to talk about living kidney donation with people you trust, such as family and friends. 

You can stop the donation process at any time and for any reason.