Living Donor Kidney Transplant

What is living donor kidney transplant?

Kidneys for transplant may come from living or deceased donors. When a living person donates one of their kidneys, the remaining kidney grows slightly larger and does the same amount of work as the original pair.

A healthy person can donate a kidney to a family member, friend or stranger as long as their blood types are compatible. If a donor and recipient have incompatible blood types, arrangements such as a paired exchange, when two donors swap recipients, may be possible.

As with any major operation, there is a chance of complications. However, kidney donors have the same life expectancy, general health and kidney function as other healthy people who are not donors. Donating a kidney doesn't affect a woman's ability to have children.
 

Benefits of living kidney donation

For recipients, there are several advantages to having a living donor:

• Shorter wait times before transplant
• Ability to plan surgery at a convenient time
• Better chance of a successful transplant
• A lower risk of complications or organ rejection 

Living kidney donor eligibility requirements

To be considered as a potential donor, you must be:

• At least 18 years old or an emancipated minor
• At or able to reach a BMI below 35 before surgery
• A nonsmoker or able to quit at least six weeks before surgery
• Not pregnant
• In good physical and mental health
• Able to understand the risks of surgery
• Able to follow instructions on surgery preparation and recovery
• Motivated by altruistic reasons

Living kidney donor evaluation process

To donate a kidney, you must successfully complete a full medical, surgical and psychosocial evaluation.

The evaluation includes tests to make sure that you and your recipient have compatible blood and tissue types. Some kidney failure patients have several compatible potential donors, while others have none. UCSF offers several programs to help patients with willing but incompatible donors. For more information on these programs, scroll down to “Options for incompatible kidney donors and recipients.”

Living kidney donor surgery

UCSF has used a minimally invasive procedure called laparoscopic donor nephrectomy to remove kidneys from living donors since 1999. We have performed hundreds of these procedures, making our program one of the most experienced in the country.

We use this minimally invasive approach for almost all of our living donors. In rare cases, due to the donor's anatomy, the surgeon performs traditional open kidney donation surgery instead. The technique used does not affect the quality or function of the donated kidney.

Laparoscopic nephrectomy procedure

In a laparoscopic donor nephrectomy, the surgeon makes small incisions, using a thin, flexible scope equipped with a camera to see inside the body and wand-like instruments to remove the kidney. Compared with traditional donation surgery that uses large incisions, laparoscopic surgery has several advantages for donors:

• Less need for strong pain medications
• Shorter recovery time in the hospital
• Faster return to normal activities
• Very low complication rate

The operation usually takes three hours. Most patients stay in the hospital for one to two days and return to work in three to four weeks.

Open nephrectomy procedure

Open donor nephrectomy was the standard procedure for removing a living donor's kidney before the laparoscopic technique was developed.

The procedure involves making a 5- to 7-inch incision on the flank (the side of the body between the ribs and the hip), dividing the muscle and removing the tip of the 12th rib. The operation typically takes three hours. Donors usually remain in the hospital for four to five days and return to work in six to eight weeks.

Kidney donor recovery and follow-up care

After discharge from the hospital, you will receive follow-up care in the transplant clinic. If you don’t live in the San Francisco Bay Area, you should stay nearby for at least one week after discharge.

You don't need to take medication or follow special diets once you recover from surgery. However, your primary care physician needs to monitor your overall health, blood pressure and kidney function for the rest of your life.

Options for incompatible kidney donors and recipients

Many kidney failure patients have family members or friends who want to donate a kidney but can’t because of incompatible blood or tissue types.  UCSF offers several programs to help these patients receive a kidney.

Paired exchange kidney transplant program

This program helps living donors ensure their friend or loved one receives a kidney even if their blood or tissue types don't match. It works by matching two recipients who have willing but incompatible donors. This type of exchange is sometimes referred to as a “family swap.”

Learn more about paired exchange kidney donation.

Advanced donation voucher program

This program allows living you to donate a kidney before your chosen recipient is medically ready for transplant. Your kidney will go to someone else on the waitlist, and your friend or loved one will receive a voucher that gives them priority on the waitlist once they’re ready for transplant surgery.  

Learn more about advanced donation vouchers.