Dear Alice,

I just found out that a friend requires a kidney transplant. I've heard that we are all equipped with two kidneys, and can live with just one. How do I find out if I can donate a kidney? What's involved in a kidney donation? Thanks!

Dear Reader,

What an admirable friend you are to consider helping in this way. Not nearly enough organs are donated. Every day in the United States, sixteen people on organ donation waiting lists die waiting for a way to prolong their lives.

There are two ways to be an organ donor. More commonly, organs come from people who have expressed a wish to donate their organs after their death. These donors (sometimes referred to as cadaveric or non-living donors) notify their family and friends of their decision and fill out an organ donor card so that after they die, their organs can prolong the life of others. People filling out an organ donor card can specify which organs they wish to donate. Hearts, livers, lungs, kidneys, pancreas, intestines, corneas, skin, connective tissue, and bone marrow all can be donated.

As a result of a severe shortage of non-living donors (most people needing a kidney transplant will be on a waiting list for one to three years), living donors are also used for about one-third of kidney donations. Because people can live a normal life with only one kidney, healthy adults may choose to donate one of their two kidneys to a family member or friend. Potential donors undergo several screenings, including:

    Compatibility testing Blood and human leukocyte antigen (HLA) typing is done to make sure that the potential donor is a good match for the recipient. This matching process minimizes the risk that the organ will later be rejected by the recipient. Close blood relatives (such as parents or siblings) are more likely to be a close tissue match than people who are not related by blood (such as spouses or friends).

    Complete physical examination
    The potential donor must be in excellent health. Blood tests, X-rays, and CAT scans will be used to make sure that both kidneys function normally and that there are no underlying health problems that could stress the remaining kidney, if the donation takes place.

Risks of donating a kidney include the hazards posed by any surgery, such as potential blood loss, infection, and allergy to the anesthesia or other complications. Donors also run the chance that some future illness or trauma could damage their remaining kidney, leaving them in need of a kidney donation.

On the plus side, according to the National Kidney Foundation, live kidney donation typically offers the recipient:

  • a shorter wait for a new kidney
  • a better match and less chance of rejection, and the possibility of taking fewer anti-rejection medications (if the donor is a close blood relative)
  • the ability to plan the surgery on an elective basis, rather than as an emergency procedure whenever a kidney becomes available
  • a kidney that usually starts working immediately after the transplant (kidneys from non-living donors may not function normally for several days or even weeks)

Once the potential donor has been approved, surgery can be scheduled. One of the donor's kidneys is removed either through several small incisions under the ribcage (laparoscopic donor nephrectomy), or though a larger incision on either the left or right side below the rib cage (open donor nephrectomy). Donors typically stay in the hospital for several days to a week and are able to return to normal activity in about 6 - 8 weeks. After the surgery, the donor's remaining kidney will increase in size to assume the function of its donated partner.

Decisions about any major surgery need to be made thoughtfully in partnership with medical experts you know and trust. If you decide to pursue becoming a living kidney donor, start by talking with your friend and your health care provider. Even if you are not a good match for your friend, or if your friend decides to explore other options, you can still fill out an organ donor card so that others can benefit from your generous spirit after your death. To learn more about becoming an organ donor after your death, log onto the U.S. Department of Health and Human Services Organ Donation web site.

Congratulations on the steps you are willing to consider in and effort help others.  You're clearly a special and dedicated friend!


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