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There are two options to stay alive when a person has end stage renal disease (ESRD): dialysis or a kidney transplant. If a person with this last stage of chronic kidney disease (CKD) qualifies for and decides on a transplant he or she can go on a waiting list to receive a kidney from a deceased donor, or ask friends and family if they are willing to donate a kidney.
There’s a lot to think about when making this important decision of becoming a living donor. So, what’s it like to donate a kidney?
The first requirement is good health. You must have normal kidney function and anatomy. Potential kidney donors will have a comprehensive physical examination. A psychological evaluation will be required to insure the potential donor’s mental health. Here is a list of what you may need to do if you want to donate a kidney:
Test results will be evaluated by the kidney transplant team. The team is composed of nephrologists, surgeons, nurses, social workers and financial counselors who will determine if the potential kidney donor is a good match.
Kidney donors may have a wide range of emotions, including joy, relief, anxiety or a sense of loss throughout the process. Even if you are elated at the thought of giving the gift of life, as a potential kidney donor you should have a support system throughout the process. Family, friends, spiritual guidance, organized support groups and mental health counseling can be helpful.
If you are matched with a kidney recipient, surgery is usually scheduled in 4-8 weeks. You will undergo a nephrectomy, or kidney removal surgery. The transplant team will explain the procedure in detail when the surgery date is set.
There are two methods to remove a kidney: an open nephrectomy and a laparoscopic nephrectomy.
In an open nephrectomy, an incision approximately 12 inches long is made in the abdomen. Sometimes the surgeon must remove a rib. The ureter (the tube that carries urine from the kidney to the bladder) is cut between the bladder and the kidney, and blood vessels are cut and clamped before the kidney is removed. The incision is closed with stitches or staples. The procedure can take up to three hours. Some benefits of open nephrectomy include:
Laparoscopic nephrectomy is minimally invasive. It uses a wand-like camera called a laparoscope to view the abdominal cavity. The kidney is then removed through a small incision. Laparoscopic surgery takes approximately two hours. Its advantages are:
A kidney donor is required to stay in the hospital for 2-7 days, depending on the type of nephrectomy performed and donor’s rate of recovery. Your health care team will carefully monitor your kidney function, blood pressure, electrolytes and fluid balance during your stay.
It is common to experience discomfort and numbness caused by severed nerves near the incision area. Pain relievers will be available for you throughout the recovery process. Deep breathing and coughing may cause discomfort because the incision is near the diaphragm, but breathing exercises can prevent pneumonia. Movement may be encouraged as soon as you’re able in order to reduce the risk of blood clots.
Kidney transplant teams do everything they can to minimize risks to donors with the intensive pre-testing and screening we’ve described. But every surgery has risks. Possible complications of kidney transplantation include:
You may feel tenderness, itching and some pain as the incision heals. Every kidney donor recovers at a different rate. It’s important to consult with a doctor to determine an appropriate activity level during recovery. Heavy lifting is not recommended for six weeks following the surgery.
The Mayo Clinic recommends a follow-up evaluation 6-9 months after the surgery. A nephrologist will check kidney function through blood work and a urine sample.
Most kidney donors live long, healthy lives. It is important for a donor to alert all their doctors and pharmacists about the donation, and to have regular appointments to monitor blood pressure and kidney function. As long as a donor exercises and maintains a healthy weight, there should be no need for dietary restrictions.
Your remaining kidney will eventually grow to compensate for the missing kidney. Having a single, larger kidney can make you more vulnerable to injury so many contact sports should be avoided. Talk with your doctor about which activities you can participate in safely.
In fact, according to a study announced by The Johns Hopkins University School of Medicine in March 2010, "researchers have found the procedure carries very little medical risk and that, in the long term, people who donate one of their kidneys are likely to live just as long as those who have two healthy ones."
Giving life by becoming a kidney donor can be very rewarding. You are providing a person the chance to live without the help of dialysis. When you consider donating a kidney, remember that you will go through a concentrated evaluation process by a kidney transplant team. They will check that you are physically and emotionally ready to donate; they want to be sure you will continue a healthy life and the recipient gets the best kidney for his or her body. If you are thinking about changing a person’s life by becoming a donor, it’s important to gather all the facts and establish a support network. To get support online, join myDaVita.com where you may find others in your same situation.
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