Considering Being a Living Kidney Donor?
What is Living Donation?
Living kidney donation is a process when someone offers one of their healthy kidneys to a kidney patient in need. We need only one kidney to live well, and if an individual is approved as a living kidney donor, one of the two kidneys is surgically removed and transplanted in the patient.
Why is it Important?
There is no cure for kidney disease. Dialysis helps keep a person with kidney failure (you may also hear it called end stage renal disease) alive. The best available treatment for most is a kidney transplant. Not everyone is healthy enough to receive a kidney transplant, nor is everyone healthy enough to be a living kidney donor.
Unfortunately, approximately 50% of patients with kidney failure will die before they receive a transplant. The main cause is the lack of available kidney donors.
There are two types of donors: living donors and deceased donors.
Living donors make a decision to donate one of their kidneys usually in response to a friend or family member who is in urgent need of a donation. There are a number of people who also decide to be a living donor because they have heard someone’s story, and are personally moved to donate one of their kidneys.
Deceased donors are people who have registered their wish to donate their organs after they die. They have discussed it with their family, and want to give the gift of life to others after they pass away. In BC & the Yukon, you can register your wish to donate as a deceased organ donor by clicking here.
Some people step forward as an "anonymous" or "non-directed donors to give a kidney to whoever needs it the most.
Why should I consider being a living kidney donor?
- you are helping someone stay alive;
- Asian, South Asian and Indigenous kidney patients are more likely to need a kidney transplant yet they wait longer and die more often because there is a significant lack of donors from the same background who are more likely to be a match;
- you only need one kidney to be healthy and live well; and
- you will know that you are amazingly healthy – both physically and mentally – if your healthcare team approves you for donation!
Common questions about living kidney donation
Who Can Donate?
• What age must I be to donate? – In BC and the Yukon you must be 19 years old. There is no upper age limit to being an organ donor. It all depends on your health. You should talk with your doctor if you are thinking about becoming a living organ donor.
• Must I be related to the kidney recipient? – No - anyone in good health may donate a kidney. The majority of living donors are related or known to the patient in need. Friends , family , acquaintances, co-workers etc. There are anonymous donors who decide to donate and these donors are called “altruistic” or “non-directed anonymous donors” (NDAD). Altruistic donors help the next compatible person on the kidney transplant waiting list.
• What might prevent me from becoming a living donor? – You must be in good physical and mental health to become a living donor. A number of chronic conditions like diabetes, high blood pressure, mental health or cancer may prevent people from being a living organ donor, however medical research is constantly breaking through some of the barriers to donation, so do not discount yourself. If you decide to apply to become a living donor, you will receive a thorough medical examination, and at the end of it all, if accepted as a living donor, you will know that you are amongst the healthiest group of Canadians.
• What if I am a smoker or consume tobacco products? – Smokers and tobacco users must quit one month prior to surgery.
• What else might disqualify me? If the transplant team believes that the potential donor is under pressure to donate or being coerced in any way, they will be declined as a donor.
• Can I be paid to be a living kidney donor? – No. In fact if a potential donor appears to have received a financial incentive, the transplant will not proceed. Anyone considering living donation must choose to be a living organ donor freely on their own, without financial reward.
What Will I Have to Go Through to Donate my Kidney?
• What kind of testing will be done on me? There will be blood tests, blood pressure, urine tests, imaging, ECG, kidney ultrasound, chest x-ray, CAT Scan of the kidney and psychological testing. After testing is completed, there is often a “cooling off period” for the potential living donor to receive the results and reflect upon them and, again, the idea of donating. Other tests might be required. Here is a link to more information about testing.
• What is the timing of these tests? Timing of the assessments is directed by the donor. The least invasive tests are done first.
• Will I have to be in the hospital for a long time? Generally, living donors spend 2 - 3 nights in the hospital and are then discharged home. There is then about a 4 – 8 week recovery period.
• Can I start the assessment as a living donor and change my mind? Absolutely, kidney donation must be completely voluntary. An individual should not feel pressure to donate.
• What medical professionals would I have access to on the transplant team? –You would see a nephrologist (kidney specialist), a transplant social worker, surgeon, transplant coordinator and transplant nurses.
• Will kidney donation affect my lifestyle? Most living donors can continue to work, drive, exercise, and participate in leisure activities. Women are able to get pregnant and have children.(It is recommended to wait 6 months post-surgery to get pregnant). One can drive as soon as they are no longer taking pain medication containing opiates that could affect your reflexes. Parents are recommended to wait 8 – 12 weeks before lifting a child that weighs more than 15 pounds. Most donors walk the same day as surgery and are recommended to be as active as possible. Do walk your dog as soon as you return home!
What are the Financial Concerns?
• In BC and the Yukon the Living Organ Donor Expense Reimbursement Program (LODERP) aims to cover expenses that may be incurred by the living donor through the process of assessment and surgery. The recipient’s medical plan covers all surgery and hospital costs for both the recipient and the donor. Here is a link to more information about what can be reimbursed It is important to know that this program has limits and you might end up having to cover additional expenses.
• Can I be paid to be a living kidney donor? –No. Organ donation is a gift. There is no monetary compensation.
Questions About Long-Term Recovery from Living Donor Surgery
• What about long-term recovery? You would likely have a doctor’s visit 2 weeks after living kidney donation, another in 6 months, a visit at one year, then annually after that. Donors should have enough psychological and social resources to recover well. Current research indicates that kidney donation does not change life expectancy or increase a person’s risks of developing kidney disease or other health problems.
•What emotions do living donors feel after surgery? Most donors feel great satisfaction in helping another person to start a new, healthy life. However some people have negative or mixed feelings. Donors report a range of positive reactions, such as an increase in self-esteem, a sense of accomplishment and pride, personal growth, interpersonal benefits and so on. That said, the fact remains that living donation is a demanding process during which potential living donors are required to face a number of stressors such as anxiety associated with having their eligibility assessed, the possibility of being refused, facing the unknown, long waits, surgery, fear of the recipient’s body rejecting the kidney. Note that a small proportion of donors report experiencing psychological difficulties, particularly in cases where the transplant did not turn out as hoped.
• Will my kidney function be affected by donating a kidney? – Generally 75% of pre-surgery kidney function is achieved within 3 months of kidney donation. You should not have poorer health after donation nor be limited physically once fully recovered from surgery. There are no dietary restrictions relating to being a living kidney donor.
• Will there be insurance implications to donating a kidney? – If one is interested in life insurance, it is recommended that it be purchased before being assessed as a living donor, in case some previously unrecognized health issues arise.
• Can I lose my job for taking time off to donate a kidney? – The Canada Labour Code – section 239, indicates that no employer shall dismiss, suspend, lay-off, demote or discipline an employee because of absence due to illness or injury. This should include the act of undergoing surgery to donate a kidney.
• What are some possible surgery complications? – Donating a kidney is considered to be major surgery. You will have general anesthetic and one could have a negative reaction to this. There could be some pain, possible infection, blood loss, blood clots, pneumonia or injury to the surrounding tissues or organs. Risks differ by donor and a potential donor should be fully informed of possible risks by talking to their transplant team before agreeing to surgery.
• What are some long-term risks? – Some donors experience high blood pressure, protein in the urine, hernia or organ impairment. Again, it is important to be aware of all possible risks before surgery.
Other Options and Support
• What if I am not a match for my recipient? – Being a match means that you have a compatible blood type and that the recipient has no antibodies against your kidney. The Living Donor Paired Exchange Program allows incompatible pairs to still proceed to transplant by pairing your duo with another. You may be requested to travel to Toronto, for instance, so that your kidney can be received by the recipient there while the Toronto-based donor would fly to Vancouver so that your partner could receive their compatible kidney. Here is a link for more information about this option.
Alternatively, you may decide to not continue with the process if you are not a match. Information about your tests and decision are only shared with the intended recipient with your permission.
• Can I talk to someone who has already been a living kidney donor before I commit to the process? – The Kidney Foundation of Canada has a peer support program that could match you up with a living donor. The support is telephone based and you would be able to get important information about that person’s first hand experience as a donor
Also, here is a link to stories from those who have already been living donors
Things to Consider When Thinking about Being a Living Kidney Donor
Are you Intellectually/Mentally Ready? – You should feel confident that you understand the risks of living kidney donation, that you are informed about the surgical procedure and that you have done your research. Visiting this website is a good first start. This video describes the surgical procedure and goes into more detail
Are you Emotionally Ready? – How would you feel if the surgery was not successful? Are you prepared to find out that you are not healthy enough to be a living kidney donor? What if you are an incompatible donor to your intended recipient? Are you prepared to live with one less organ? How would you feel if the surgery was successful but the recipient of your kidney went on to lead a life that abused that kidney?
Are you Physically Ready? – Can you withstand major surgery? Do you have a healthy organ to donate? Do you have a safe, supportive environment within which to recover from surgery?
Are you Financially Ready? – In BC and the Yukon, the Living Organ Donor Expense Reimbursement Program (LODERP) aims to cover expenses that may be incurred by the living donor through the process of assessment and surgery. The recipient’s medical plan covers all surgery and hospital costs for both the recipient and the donor. Here is a link to more information about what can be reimbursed. It is important to understand that this program has limits and you might end up having to cover additional expenses.
Are you Spiritually Ready to Donate? – One should look at their own motives for donating. Most living donors benefit from the kidney donation as well as the recipient. You would be giving the gift of life to another individual. It should be a selfless choice.
Making the Decision
Making the decision to become a living kidney donor is probably one of the biggest decisions a person can make during their lifetime. The decision must be a well-informed one that is “right” for the potential donor. Whether the potential donor is asked to consider donating one of their kidneys, or comes forward of their own accord, it is natural to have some concerns about the decision. There are many factors to consider including the risks and benefits of donation, and the emotional and practical impact the donation will have on the donor, their family, work and social life. Who will take care of my regular household responsibilities during evaluation, surgery and recovery? What about child care, pet responsibilities, household chores, cleaning cooking and transportation?
More than one potential donor?
Sometimes there is more than one willing donor for a specific recipient. For example, several family members or friends may be willing donors and suitable candidates. To see who might be best suited to donate their kidney, all aspects of living donation must be considered: physical, emotional, financial and practical. The healthcare team will help with the evaluation.
People to talk to
The final decision belongs to the donor alone. But getting some informed help, and discussing thoughts, feelings and questions can help the donor to see just how prepared they are to donate a kidney. People to talk with may include family members, close friends, religious or spiritual advisors, financial advisors, a living donor.
I Am Ready to Take the Next Step, What do I do Next?
• If you have a recipient in mind and know which of the three hospitals in BC that person has been referred, please call the transplant team there:
St Paul’s Hospital – 1-877-922-9822 or 604-806-9027
Vancouver General Hospital – 1-855-875-5182 or 604-875-5182
BC Children’s Hospital – 604-875-3613
If you do not have a person in mind as a recipient (anonymous donor) or do not know which hospital to call, please call BC Transplant at 604-877-2240 or 1-800-663-6189.
Once you are registered, a package of information about being a living donor will be mailed to you.