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LIVING DONATION
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What is living donation? Living donation takes place when a living person donates an organ or part of an organ to be transplanted into a loved one in need. The living donor is most often a close family member, such as a parent, child, brother or sister. A living donor can also be a more distant family member, spouse or friend. What organs can come from living donors? The organ most commonly given by a living donor is the kidney. People usually have two kidneys, and one is all that is needed to live a normal life. Parts of other organs including the lung, liver and pancreas have also been transplanted from living donors. What are the advantages of living donation over cadaveric donation? Living kidney transplantation has a number of advantages compared with kidney transplantation from a person who has died (cadaver donor). First, since the living kidney donor is usually a close relative of the person getting the transplant, there is a better match and less chance of rejection. Second, the transplant can be scheduled ahead of time, something that cannot be done when the patient is on a waiting list for a cadaveric kidney. Third, kidneys that come from living donors begin to function immediately after the transplant while cadaveric kidneys may take several days or weeks before they begin to function normally. What determines who can become a living donor? Acceptable living donors are usually between 18 and 60 years of age and are often close relatives of the intended recipient, although living unrelated donation is possible. The prospective donor must have a compatible blood and tissue type as determined by tests of the donor and recipient and must be free of hereditary diseases affecting close family members such as cancer, diabetes, kidney disease and heart disease. If these criteria are met, the donor is carefully evaluated by a physical examination through tests to assure normal kidney function and studies to show the presence of two normal kidneys. The donor's physicians may recommend a psychological evaluation as well. The health care team at the transplant center then decide whether to accept the donor. I am not a close relative. Can I still be a living donor? Some transplant centers are undertaking transplantation from living unrelated donors. A living unrelated donor is usually someone who has emotional ties to the recipient, such as a close friend. There have been some cases of strangers making living donations as well. Living unrelated kidney transplantation has been quite successful in most cases. How will living donation affect me? Studies have shown that one kidney is enough to keep the body healthy by removing wastes and excess fluid from the blood. Living donation does not change life expectancy, nor does it increase the chances of kidney failure. After recovery from the surgery, you can continue to lead a normal life and participate in normal activities. The usual recovery time after the surgery is short, and you can generally resume your home and working lives within two to six weeks. Suppose someone decides against being a living donor? A decision to become a living donor should be voluntary and free from internal or family pressures. Individuals have the right, after discussing and considering the facts, to decide that kidney donation is not for them. Likewise, individuals who have kidney failure have the right to decide that they do not want a transplant. The patient must live with the disease, and he or she alone has the right to decide what is to be done. That decision, as well as the donor's, must be respected. What does the operation involve? Once all the tests are completed, the donor and transplant operations are scheduled. For surgery, the donor and recipient are usually in adjacent operating rooms. The kidney is carefully removed and transplanted into the recipient. After the operation, the hospital stay for the donor is usually about a week. The donor may visit the doctor's office or clinic to make sure the wound is healing well and that recovery is proceeding as expected. In general, no further treatments or office visits are needed. How much does living donation cost? Who pays? The costs of the donation, which include laboratory, x-ray and doctors' and hospital charges, are paid by Medicare or the recipient's insurance. There is no cost to the donor. However, the donor usually is not paid for time off from work. Some employers may allow this time to be taken as sick leave. Are transplants from living donors always successful? It is important to realize that, although living related kidney transplants are highly successful, problems may occur. Sometimes, the kidney is lost to rejection, or the original disease that caused kidney failure may come back in the transplant, causing it to fail.
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