What is living donation?
Living donation is when a living person donates an organ, or part of an organ, to a person in need of a transplant. Virginia’s transplant centers perform kidney and liver living donor transplants. Living kidney donation is possible because we can live a healthy life with one functioning kidney. Living liver donation is possible because the liver consists of two lobes, one of which can be donated to someone in need. Both lobes will regenerate to normal size and function generally within 6 weeks.
Why is living donation important?
Each year, less than a third of the patients on the national waiting list receive a transplant, and on average, 17 people die each day while waiting. Our limited supply of deceased donor organs cannot meet growing demand. Living donation is one way we can give more Americans access to the life-saving transplant they need.
Other benefits of living donation include:
- The recipient can be transplanted while in better health and better able to tolerate the surgery.
- Living donor organs are often better quality and last up to two times longer than deceased donor organs.
- Kidney disease patients can avoid years of dialysis, and for some it may be their only option to ever receive an organ.
- The surgery can be scheduled at a time convenient for both the donor and the recipient.
Who can be a living donor?
Living donors can donate to a relative, spouse, friend, colleague, or even a stranger, which is called altruistic or non-directed donation. Donors must be in good physical and mental health and able to complete a medical and psychosocial evaluation at a transplant center to ensure you are healthy enough for surgery.
Transplant centers may differ in their age and BMI limits, but common medical conditions that may prevent someone from being a living donor include high blood pressure, diabetes, heart disease, and cancer. To find out more, contact the transplant center where the recipient is listed, or if interested in a non-designated donation contact the transplant center of your choice.
How does living donation differ from deceased donation?
Living donors are opting to give a specific organ to someone in need while they are still alive. Deceased donors are people who registered on their state organ donation registry to make the decision to donate their organs, eyes and tissues to someone in need upon the time of their death.
Registering as an organ donor at donatelifevirginia.org does not commit you in any way to become a living donor. Alternatively, being a living donor does not place you on the donor registry – you must do this separately if you wish to donate your organs upon death. To learn more about deceased donation and Virginia’s organ donor registry, click here.
What is involved in the evaluation?
The evaluation is designed to protect the donor and ensures that you are healthy enough for the surgery and are making an informed decision. You will undergo both physical and psychosocial examinations. Testing can vary depending on the organ and donor’s age but generally includes:
- A complete physical and history
- Psychological evaluation
- Blood tests for purposes of matching and health evaluation
- Chest x-ray
- Urine testing
- Radiological tests to look at the organ and the blood vessel supply
- Cancer screening such as colonoscopy, prostate exam, skin cancer screening
- Mammogram and gynecological exam for women
If it is determined that you are a match for your recipient, you will then meet with a living donor team which includes an Independent Living Donor Advocate (ILDA). This team is separate from the recipient’s care team, and is designed to ensure you are physically and psychologically prepared to donate an organ and understand the risks and benefits of being a living organ donor. All results from your evaluation and all conversations between you and your living donor team will be kept confidential.
What is the recovery time?
The recovery time varies by person and donated organ but you should plan on spending approximately 2-6 days in the hospital after surgery and about 6 weeks before you are able to resume normal physical activities. Contact a transplant center for more detailed information regarding recovery.
What if I am not a match?
For kidney donations, if you do not match your intended recipient you can take part in a “paired kidney exchange”. This is where the transplant center pairs you with another living donor who is not a match for their intended recipient and the donations are “swapped” between the two recipients. You can also do a non-directed or altruistic donation. This is when you do not know who will be the recipient and the match is made purely on medical compatibility and need.
What are recent advances in living organ donation?
Today, kidney removals (nephrectomies) for living donors can be done using laparoscopic surgery which requires a few small keyhole incisions instead of one large incision. This type of surgery reduces pain and recovery time for the donor. Some centers are also using robotic-assisted surgical systems that provide the surgeon better control and precision and further decreases pain and shortens recovery for the donor.
What are the risks?
The overall risk involved in living donation is the same as any major surgery and is considered low. Specific risks include pain, infection, blood loss, blood clots, reactions to anesthesia, pneumonia, and injury to surrounding tissue or other organs. The donor evaluation provides for a way of determining any additional specific risks for you. You should discuss the risks fully and carefully with your care team and your family. The positive aspects of living donation are many, but you need to be comfortable with your decision and free of undue pressure or influence from others.
What should I consider when making a decision?
Donating an organ is a generous, life-giving act, but it is not to be approached lightly. Careful consideration and educating yourself about the process and risks are important. Ask yourself:
- Am I prepared if medical testing uncovers an unknown health problem?
- If a health problem unrelated to the donation is uncovered will my health insurance cover the expenses?
- Will I be able to take the time off work for testing, surgery and the recovery?
- Can I afford travel costs that may be involved?
- Am I emotionally, mentally and spiritually ready to donate?
- How will I handle being turned down as a donor?
- Am I prepared for how donation or the inability to donate may affect my relationship with the person I want to donate to?
- Will I be able to deal with the organ failing or being rejected by the recipient?
- Do I have a good support system to help me throughout the process and after donation?
- If I am not a match with the intended recipient am I willing to take part in other types of donation such as paired exchanges?
The living donor team and your advocate can help you work through these questions and other concerns. For further items to consider, visit “Being Asked to Donate” from the United Network for Organ Sharing.
What should I expect from a transplant program?
Your living donor team should provide education on all aspects of donation and ensure that you are able to make an informed decision that is voluntary and free from undue influence. Your Independent Living Donor Advocate (ILDA) will guide you in understanding all phases of the living donation process, including:
- Consent process
- Risks and benefits
- Other options available to the recipient
- Medical and psychosocial evaluations
- Pre- and post-operative care and follow-up
You should also be provided with program-specific transplant recipient outcomes, financial guidance, nutritional and psychosocial support.
Who pays for the medical expenses?
The costs for the medical testing, surgery and post-operative care are covered by the recipient’s health insurance. However, you will be responsible for treatment of any medical issues discovered during the evaluation that are not related to the donation. Future issues that result from the donation may not be covered by the recipient’s insurance. Other costs that are not covered include travel expenses, loss of wages from missed work, and routine post-surgical health maintenance. If you are employed, you should learn about your company’s paid sick leave, disability and FMLA policies if applicable. There are many organizations that provide financial resources for living donors for uncovered costs. The National Living Donor Assistance Program is one such resource; contact the transplant center nearest you for more information and other programs.
How do I start the process?
If you have a designated recipient, you can begin the process by contacting the recipient’s transplant center. Many centers have a form on their website you can submit to begin the process, or you can call the transplant center and ask to speak with the living donor coordinator for the organ you wish to donate.
Remember, this act is completely voluntary; you can delay or stop the process at any time. Your reasons for choosing to not donate, or if you are found not be medically suitable, will remain confidential and not shared with the recipient or other family members.
If you are considering donating a kidney or liver, begin the screening process by clicking on the link to your preferred transplant center.
You can only sign up to be a living donor at a transplant center that performs living donor transplants. Signing up on here will only register you for deceased organ donation.
Contact Your Nearest Transplant Center
University of Virginia Transplant Center
1215 Lee Street, Charlottesville, 22903
Adult: heart, kidney, lung, pancreas, kidney/pancreas, liver
Pediatric: heart, liver, kidney
Sentara Norfolk General Hospital
600 Gresham Drive, Norfolk, 23507
Adult: heart, kidney, pancreas
Children’s Hospital of The King’s Daughters
601 Children’s Lane, Norfolk, 23507
Inova Fairfax Hospital
8110 Gatehouse Road, Falls Church, 22042
Adult: heart, kidney, lung, pancreas, kidney/pancreas
Virginia Transplant Center, Henrico Doctors’ Hospital
1602 Skipwith Road, Richmond, 23229
Hunter Holmes McGuire VA Medical Center
1201 Broad Rock Boulevard, Richmond, 23249
VCU Health Hume-Lee Transplant Center
1250 East Marshall Street, Richmond 23298
Adult: kidney, liver, pancreas, heart