Living Kidney Donor Transplant

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 non-donors. Donating a kidney doesn't affect a woman's ability to have children. Any healthy person can safely donate a kidney.

Having a living donor benefits patients in several ways:

• Better long-term results
• Shorter wait time until transplant
• Ability to plan surgery at a convenient time
• Lower risk of complications or organ rejection and better early function of the transplanted kidney

Donor eligibility and evaluation

Potential donors must meet certain criteria to be considered. They must be at least 18 years old (with the exception of emancipated minors) and must not have any of the following:

• Uncontrollable hypertension
• History of pulmonary embolism or recurrent thrombosis (blood clots)
• Bleeding disorders
• Uncontrollable psychiatric illness
• Morbid obesity
• Uncontrollable cardiovascular disease
• Chronic lung disease with impairment of oxygenation or ventilation
• History of melanoma
• History of metastatic cancer
• Bilateral or recurrent kidney stones
• Chronic kidney disease of stage 3 or less
• Proteinuria, or high levels of protein in the blood (more than 300 mg/d, excluding postural proteinuria
• HIV infection

The donor must be in excellent health, well informed about transplantation and able to give informed consent. Before donating a kidney, the person must successfully complete a full medical, surgical and psychosocial evaluation.

The evaluation will include tests to ensure that the donor and recipient have compatible blood and tissue types. Some patients have several family members who are compatible potential donors. In other families, none are suitable. UCSF offers several programs to help patients with willing but incompatible donors (see "Special Programs for Living Donor Kidney Transplantation," below).

Laporoscopic (minimally invasive) donor surgery

UCSF has been using 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.

In a laparoscopic donor nephrectomy, the surgeon uses very small incisions, a thin, flexible scope equipped with a camera to view inside the body, and wand-like instruments to remove the kidney. Compared to the kidney donation procedure used in the past, laparascopic surgery has several advantages for donors:

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

The operation usually takes three hours. Most patients require a hospital stay of only two to three days and return to work within three to four weeks.

In some cases, due to the donor's individual anatomy, the surgeon decides to perform traditional open kidney donation surgery instead. This procedure was standard for removing a living donor's kidney before the laparascopic technique was developed.

The traditional open procedure involves making a 5- to 7-inch incision on the flank, dividing the muscle and removing the tip of the twelfth rib. The operation typically takes three hours. Donors remain in the hospital four to five days on average, and return to work in six to eight weeks.

The technique used does not affect the quality and function of the donated kidney.

Donor follow-up care

After discharge from the hospital, the donor receives follow-up care in the transplant clinic. Donors who live outside the San Francisco region should stay in the area for at least a week after discharge.

Donors don't need medication or special diets once they recover from surgery. They do need lifelong monitoring of their overall health, blood pressure and kidney function.

Special programs for living donor kidney transplantation

Many patients have family members or friends who wish to donate a kidney but are not able to because their blood type or tissue type doesn't match the recipient.  In such cases, the donor and recipient are said to be "incompatible." UCSF offers several programs to help these patients receive a kidney.

Paired exchange kidney transplant or "family swap"

This program is another way for a living donor to help a friend or loved one get a kidney even though their blood or tissue types don't match. It works by matching two recipients who have willing but incompatible donors.

For more information, see our page on paired exchange kidney donation.

Advanced donation ("voucher") program

This program allows living kidney donors to donate a kidney at a time of their choosing, rather than waiting until their chosen recipient is medically ready for the transplant. The donor provides a "voucher" to one chosen recipient (or more than one potential recipient, in the case of family vouchers), who is prioritized for a living donor transplant when ready.

For details about how this works, visit our Advanced Donation Kidney Transplant Program page.