Living donation offers another choice for some transplant candidates, reducing their time on the waiting list and leading to better long term outcomes for the recipient.
A living donor is an option for patients who otherwise may face a lengthy wait for an organ from a deceased donor. To spare an individual a long and uncertain wait, relatives, loved ones, friends, and even individuals who wish to remain anonymous may serve as living donors.
Kidney and liver transplant candidates who are able to receive a living donor transplant can receive the best quality organ much sooner, often in less than a year.
- More than 100,000 people are on the national transplant waiting list.
- More than 85% of patients waiting are in need of a kidney.
- 11% of patients waiting are in need of a liver.
- In 2020, 5,700 more lives were saved through the generosity of living donors.
Facts about Living Donation
Want to learn more about living donation? Here are some key facts:
- Living donation is an opportunity to save a life while you are still alive.
- Living organ donation and transplantation was developed as a direct result of the critical shortage of deceased donors.
- Living donors don’t have to be related to their recipients. On average, 1 in 4 living donors are not biologically related to the recipient.
- Patients who receive a living donor transplant are removed from the national transplant waiting list, making the gift of a deceased donor kidney or liver available for someone else in need.
If you are considering being a living donor, it’s important to note that living donation is not included in your deceased donor registration. In 2021, you will be able to register your interest in being a living donor in the National Donate Life Living Donor Registry (check back for updated information). A living donor transplant program will conduct a full evaluation to determine your eligibility to be a living donor.
The National Donate Life Living Donor Registry
In an effort to streamline the living donation process and help save more lives, DLA is currently working with funding partner, Fresenius Medical Care Foundation, to develop the National Donate Life Living Donor Registry. Launching in 2021, the Living Donor Registry will allow individuals to register their interest in being a living kidney donor and receive a preliminary at-home testing kit to help with further evaluation by a living donor transplant program.
Types of Living Donation
In a directed donation, the living donor names the specific person to receive the transplant. This is the most common type of living donation. In a directed donation, the living donor may be:
- a biological relative, such as a parent, brother, sister, or adult child
- a biologically unrelated person who has a personal or social connection with the transplant candidate, such as a spouse or significant other, a friend or a coworker
- a biologically unrelated person who has heard about the transplant candidate’s need
If tests reveal that the living donor would not be a good medical match, paired donation may be an option.
In non-directed donation, the living donor does not name the specific person to receive transplant. The match is determined based on medical compatibility with a patient on the national transplant waiting list. The living donor and recipient may meet at some time, if they both agree, and depending on transplant hospital policy and guidance.
Kidney Paired Donation
According to UNOS, kidney paired donation (KPD), also called kidney exchange, occurs when a transplant candidate has someone who wants to donate a kidney to them, but tests reveal that the kidney would not be a good medical match. Kidney paired donation gives that transplant candidate another option: swapping living donor kidneys so each recipient receives a compatible transplant.
This type of exchange often involves multiple living kidney donor/transplant candidate pairs. View transplant centers that currently participate in the OPTN Kidney Paired Donation (KPD) Pilot Project.
Who Can Donate?
Living donors should be in good overall physical and mental health and older than 18 years of age. Some medical conditions could prevent an individual from being a living donor. Since some donor health conditions could harm a transplant recipient, it is important that living donor candidates share all information about their physical and mental health. It is important to be fully informed of the known risks involved with donating and complete a full medical and psychosocial evaluation. The decision to donate should be completely voluntary and free of pressure or guilt, and donors can delay or stop the process at any time.
Risks of Living Donation
Living donation is a major surgery, and all potential complications of major surgery apply. These complications may include:
- infection at the incision site
- incisional hernia
- blood clots
- potential need for blood transfusions
- side effects associated with allergic reactions to the anesthesia
According to the National Kidney Foundation, living donors in studies report a boost in self-esteem, and 9 out of 10 say they would do it again. However, living donors may also experience negative psychological symptoms right after donation or later. The transplanted organ may not work right away. There is also the chance it will not work at all. Donors may feel sad, anxious, angry, or resentful after surgery. Donation may change the relationship between donor and recipient.
The best source of information about risks and expected donor outcomes is the transplant team. In addition, it is important to take an active role in learning more about these potential surgical risks and long-term complications.
Living donors must be made aware of the physical and psychological risks involved before they consent to donate an organ. Please discuss all feelings, questions and concerns with a transplant professional and/or social worker.
How to Become a Living Donor
For more information on how to start the process of becoming a living donor, contact a living donor transplant program in your area. You can find contact information for living donor transplant programs and other helpful patient information at UNOS TransplantLiving.org.
Laurell and Katherine’s Living Donation Story
“Because of Katherine, we are planning for life again,” says Laurell. “Katherine is a beautiful soul.” Click here to read their full story.
References: TransplantLiving.org, UNOS.org, OPTN.transplant.HRSA.gov, and Kidney.org.
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