Preparing for your living kidney donation

If you decide to be a living kidney donor, there are steps you will go through to prepare for the surgery. From the full health evaluation to the surgery itself, here is what you need to know to prepare for the process.

What is the evaluation process for a living kidney donation?

To know if you are healthy enough to donate a kidney, you will need a full health evaluation by a transplant team. Your doctor or your kidney recipient's (the person who gets your kidney) doctor may recommend a transplant center. As part of the evaluation, you will have many tests and exams. The results will help the transplant team decide if you are ready and healthy enough to be a living kidney donor.

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

• Blood and urine (pee) tests
• Heart and lung tests
• Blood pressure check
• Ultrasound or other imaging of your kidneys
• Antibody test (antibodies are proteins in your blood that protect your body from foreign things, such as germs and viruses) 
• Cancer screening, including colonoscopy (test for colon cancer), mammogram (test for breast cancer), Pap smear (test for cervical cancer) and/or prostate blood test (test for prostate cancer)
• Dental exam

You can get all of these tests at a time that fits with your schedule without having to stay overnight in a hospital. The evaluation may take only one day or you may have several days of appointments. If you need to do anything special to prepare for one of the tests, your transplant team will let you know.

As part of the medical evaluation, you will meet with a transplant 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. 

In addition to medical and psychosocial evaluation, you will also meet with a transplant surgeon for surgical evaluation and discuss the kidney donation surgery in greater detail. 

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

See a list of health conditions that may prevent you from donating a kidney.

How do I know if I am a good match for the person receiving my kidney?

You will have blood and antibody tests to see if your kidney is a good match for the recipient. 

Your immune system finds anything that should not be inside your body and attacks it to keep you healthy. The immune system protects our bodies by fighting anything it senses can hurt us, such as bacteria from spoiled food or viruses like the flu. When your recipient gets your donated kidney, their immune system will notice right away that the new kidney is different from the rest of their body. Then, it will start to attack the new kidney as if it were a disease.  

To lower the chances of this happening, your transplant team will start by making sure your blood type works with the recipient's blood type. There are four blood types: O, A, B and AB. If your blood type is very similar to your recipient's, there is a lower chance that their immune system will try to fight the new kidney.

If you are not a good match for your potential recipient, you can still help them get a living donor transplant through a paired kidney exchange. 

How can I prepare for kidney donation surgery?

The transplant team will work with you to schedule the date of your surgery. You will want to take these steps to prepare for surgery.

Stay as healthy as possible

Take steps to make sure your body stays healthy:

• Be active for at least 30 minutes on most days of the week. For example, you may want to take a walk every day before surgery. Being active can help you recover faster and more easily after surgery.
• Quit smoking before your surgery date. Smoking can raise the chance of health problems from surgery.
• Stop drinking alcohol or drink less alcohol. Do not start drinking after surgery until your transplant team tells you that you can.
• Stop taking aspirin or nonsteroidal medicines like ibuprofen for seven days before surgery (or as directed by your transplant team). 
• Follow a healthy eating pattern that includes fruits, vegetables, whole grains and lean protein. This can help keep your body strong.

Find healthy recipes on Kidney Kitchen.

Go to a final meeting with the transplant team

Two to three days before surgery, you will go to a final meeting with the transplant team to have any last tests and questions answered. They will tell you what to do the day before and the day of your surgery.

Before the final meeting, write down a list of questions to ask the transplant team, such as:

• Can I take my prescription medicines before surgery? If so, when should I take them?
• What medicines should I not take before surgery?
• When do I need to stop eating and drinking before surgery?
• When do I need to arrive at the hospital?

Pack for the hospital

You may want to pack a few things to be more comfortable during your hospital stay, including:

• Loose-fitting, comfortable clothes like sweatpants and t-shirts that will not rub against your surgery site
• Non-slip slippers or shoes 
• A small, firm pillow to support your belly after surgery, such as to press to your belly when you are getting up
• Personal care items, such as your toothbrush, toothpaste, comb and soap
• Books, magazines or music to keep you busy during your hospital stay

Prepare your home, friends and family for recovery

You may feel tired or have some pain after surgery. You may want to prepare your home beforehand:

• Have a chair with arms to push yourself as you get up and down.
• Set up a bed on the main floor of your house to avoid climbing stairs.
• Stock up on bandages and first aid supplies to clean your surgery site.
• Ask a family member or friend to help shop, cook meals, care for your kids or pets and run errands until you recover.
• Prepare for any costs during the donation process, such as travel, parking and childcare. You will not be paid for donating your kidney (it is against the law) but there may be programs to help you cover some costs during the donation process.

Take time off work to recover after surgery.

What happens on the day of surgery?

1. You will be placed on your back on the surgery table. In most cases, you and your recipient will be in nearby operating rooms. 
2. You will be given anesthesia, a medicine to put you to sleep during surgery. 
3. The surgeon will make a cut on your belly and carefully remove your kidney. The surgeon will close the skin cut and you will go to a recovery room. The surgery takes two to three hours.

Read more about what kidney donation surgery is like.

What is recovery like after surgery and how long does it take?

You will usually recover in the hospital for one to three days. During recovery, you can expect to:

• Have some pain that you can take medicine for, especially the first week after surgery
• Have trouble getting up and around because of belly pain
• Feel weak and tired

After leaving the hospital, most donors have to rest at home, usually for about a week while their body heals. Most donors can return to their normal activities after four to six weeks. Your transplant team will give you instructions on how to care for the surgical site and when to follow-up to make sure you are healing appropriately.

Your transplant center will follow up with you for at least two years after donation to make sure that you are doing well and remain healthy. Make sure you see your regular doctor each year for checkups, including checks of your blood pressure and kidney health.

Learn more about side effects or health problems after donating a kidney.