Who can be my living donor?

  • Each transplant center may have slightly different criteria for who is a good living donor for you.

  • In general anyone who is healthy and over the age of 18 can donate.

  • It could be your immediate blood relative such as mom, dad, brother, sister and children. It could be your 2nd degree relatives such a cousins, aunt, uncle, etc. It could also be your wife, sister in law, bother in law or close friend who are emotionally related to you.

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What blood group should my donor be?

  • If your blood group is A, you can receive a kidney from a donor with A or O blood type,

  • If your blood group is B, you can receive a kidney from a donor with B or O blood type,

  • If your blood group is O, you can receive a kidney from a donor with O blood type and

  • If your blood group is AB type, you can receive organs from any blood type (A, B, AB or O).

  • Donors with O blood type can give an organ to any blood type, and patients with AB blood type can receive kidney from any blood type. Rh positivity and negativity does not matter. That means Rh positive or negative patients can get kidneys from a positive or negative donor. In addition, blood type A is subdivided into A1 and A2. A2 donors may be able to give kidney to O patients. You are advised to discuss this issue with the transplant center.

  • All persons who are interested in donating should contact your transplant center to discuss compatibility. Even if your potential donor is not compatible with you, the center may be able to swap donors (paired exchange) with a donor who is compatible with you.

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Is there a benefit for good matching?

Yes. There is a benefit for good matching (6 antigen match or 3 antigen match). However, 0 match transplants can do very well and is far better than waiting for a deceased donor transplants. Kidney without any match is far superior to long-term dialysis treatment.

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How old can my donor be?

Age of the donor does matter. Donor has to be above 18 years of age. It is preferable to have a donor who is less than 60 or 65 years. However, certain older donors who are physically fit with minimal or no health issues with good kidney function can be an acceptable donor.

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What should be my donors weight or Body Mass Index (BMI) be for being an acceptable donor?

  • Donor BMI is more important than donor weight.

  • It is preferable that your donor BMI is optimal. Most of the transplant centers will only accept a donor when BMI is < 32 kg/m2 and occasionally between 32- 35 kg/m2 especially in cases with good muscle mass contributing to donors weight.

  • Patients are advised to discuss this issue with the transplant center.

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Can I get a donor from my home country?

  • Yes. You should discuss this with your transplant coordinator to help you with this process.

  • You are permitted to get donor who is related to you from your home country (parents, brother, cousin, etc).

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Can a donor be paid for kidney donation?

  • Absolutely not. Donor has to be purely altruistic.

  • The National Organ Transplant Act (NOTA) is a federal law that makes this illegal.

  • International guidelines absolutely prohibit and even condemn payment to a kidney donor or to his/her families by the recipient.

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What kind of health problems will interfere with kidney donation?

  • In general, donor has to be in good health. Kidney donor should not have significant high blood pressure or diabetes.

  • Kidney donors should have two normal functioning kidneys without any significant protein or blood in urine.

  • Kidney donors should not have active infections including TB or chronic infections such as hepatitis and HIV is important.

  • Kidney donors should not have cancer (other than past skin or brain cancers).

  • Kidney donors should not have major heart, lung, liver or brain disease.

  • Kidney donors who are blood thinners are usually not accepted as donors.

  • Kidney donor acceptance criteria vary from one center to another. Hence, it is preferred that the donor and patient discuss all aspects of donation with the transplant center

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What tests are required for evaluating a kidney donor?

  • Blood tests [blood grouping, HLA testing, complete blood count, coagulation tests, kidney function tests, liver function tests, test for diabetes, cholesterol,

  • Infections : Test for infections including Hepatitis A,B,C, HIV, TB, Varicella, CMV, EBV.

  • X rays: chest X ray

  • Heart: cardiac testing [EKG, ECHO and stress test as necessary)],

  • Urine: urine test (urine analysis, urine for protein, creatinine),

  • Kidney Function test: Evaluation of total kidney function by either 24 hour urine test or nuclear medicine GFR testing will be necessary.

  • Other test: Pregnancy test and age appropriate cancer screening tests like PAP smear, colonoscopy, PSA testing will be done where appropriate.

  • Special tests: Based on geography and donor history - additional tests may be necessary. All donors have to discuss more specifics with their transplant center.

  • Each transplant center have their own criteria for kidney donor evaluation.

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My donor has high blood pressure, - is that acceptable for kidney donation?

Some transplant center will not accept donors with high BP. However, some centers will accept donors with mild high BP under control with one medicine without any end organ damage (heart, brain, kidneys). Younger patients with high BP are not usually candidates for donation. Donors with mild BP with abnormal blood sugar are not usually acceptable as kidney donors. Patients are advised to discuss this issue with the transplant center.

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My donor has mild elevation of blood sugar. Is that acceptable for kidney donation?

Some transplant center will not accept donors with mild elevation in fasting blood sugar. However, some centers will accept donors with mildly elevated blood sugar without any organ damage (heart, brain, kidneys). Younger patients with elevated blood sugar and those who also have combination of high BP and obesity with elevated blood sugar are usually not acceptable for donation. Patients with diabetes on medications are not acceptable for kidney donation. Patients are advised to discuss this issue with the transplant center.

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My donor has cholesterol - is that acceptable for kidney donation?

Elevated cholesterol, which is under control with diet, exercise or medications, is acceptable medical condition for kidney donation. Patients are advised to discuss this issue with the transplant center.

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My donor has blood in the urine. Can that person be a donor?

Blood in the urine can be benign or may be an early manifestation of kidney disease. Blood urine can be secondary to urine test (during menstrual cycle) and have to repeated after menstrual cycle. Persistent blood in the urine can be secondary to urine infection, stones in the urinary track or intrinsic kidney disease. Diseases like glomerulonephritidis, Thin Membrane Disease, Familial Alport’s syndrome can present as asymptomatic hematuria. Such an individual may require extensive work-up including kidney biopsy to find out the cause for blood in the urine. Patients are advised to discuss this issue with the transplant center. Transplant center will determine the candidacy of the donor based on complete evaluation.

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My donor has protein in the urine. Can that person be a donor?

Protein in the urine may also be benign or may be an early manifestation of kidney disease. Protein in the urine can be secondary to orthostatic proteinuria (change in posture leading to proteinuria). Persistent protein in the urine can be secondary to intrinsic kidney disease Such an individual may require extensive work-up including requiring a kidney biopsy. Patients are advised to discuss this issue with the transplant center. The transplant center will determine the candidacy of the donor based on complete evaluation.

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My donor has heart issues. Can that person be a donor?

Mild heart condition such as mild valve disease, sinus tachycardia, etc are acceptable conditions for kidney donation. However, potential donors with serous conditions such as coronary artery disease, congestive heart failure, and arrhythmias requiring medications, or those with significant valve disease are not acceptable candidates for kidney donation. Patients are advised to discuss this issue with the transplant center.

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Can my donor go through pregnancy after kidney donation?

Pregnancy is not a contra-indication after donation. However, it is recommended to wait and plan for pregnancy at least 1 year post donation.

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When can my donor return back to work after donation?

Patients can return back to work once they are off pain medications and after removal of all sutures or staples. Donors who have undergone laproscopic donation can return earlier that those who have had open donor nephrectomy surgery. It is generally recommended to wait for 1 month before returning to work. However, some donors have returned to work in 2 -3 weeks. Those donors who have heavy-duty work (weight lifting) should wait for a longer period. Patients are advised to discuss this issue with the transplant center.

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What restrictions will donor have after surgery and how long?

Donors have minimal restrictions and are as follows: avoid heavy weigh lifting for 4-6 weeks and avoid driving until complete recovery and till off pain medications.

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Will the surgeon remove the right kidney or left kidney for donation?

Usually left kidney is removed for donation as it has longer renal vein. However, if it is necessary the surgeon may remove the right kidney instead of the left kidney. Right kidney will be preferred if the left kidney has multiple vessels or more than 1 ureter. This is a choice of a surgeon and hence patients are advised to discuss this issue with the transplant center.

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How long my donor will require to stay in the hospital?

It varies from one center to another and it also depends on laparoscopic donation versus open donor nephrectomy surgery. Typically after laparoscopic donor surgery with expected post donation course, the donor will be able to go home by day #2 or 3 (day #0 is the day of surgery). However, some centers discharge donors on day #2 and some by day #5. Donors undergoing open nephrectomy will have to stay longer in hospital.

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What are the long -term consequences of kidney donation?

Kidney donation is safe. There is a very small but definitive risk after donation as donors live with one kidney as one can meet with Motor vehicular accident or some other injury resulting in damage to the solitary kidney (this is extremely rare). There is a slightly higher chance of developing mild increase in BP and protein in the urine compared to those who haven’t donated. In recent years it has been observed that certain ethnic / racial groups (Hispanics, African Americans) have a higher chance of developing kidney disease many years (decades) after donation.

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What follow-up is required after kidney donation?

In general all donors are seen 1-2 times within first few weeks post donation. Subsequently, they have to follow at the transplant center or through primary care MD at 6, 12 and 24 months post donation. Beyond 2 years, follow-up with the primary care doctor for general health maintenance on yearly basis is strongly advised. At these visits they should undergo Blood Pressure check as well as evaluation of protein in urine and blood test for kidney function.

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Can I do anything to prevent kidney failure after donation?

Maintaining optimal weight, controlling BP and diabetes (if it were to occur) and a healthy lifestyle post donation is important to prevent kidney disease.

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What is the donor exchange program?

  • If a recipient (Recipient A) has a donor (Donor A) and Donor A is not suitable for donation to an individual either due to blood group mismatch or has a positive cross match, such a pair is considered for donor exchange program. This means this donor (Donor A) can give kidney to some one other recipient (Recipient B) and another donor (Donor B) will be able to give kidney to the 1st recipient (Recipient A). This can be done locally within the center, regionally or through national donor exchange program (National Kidney Registry).

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