Can I donate a kidney to my friend?

Dear Reader,  

Considering donating a kidney is a generous decision—there aren’t nearly enough kidneys available for the patients who need them. Most humans are born with two kidneys, but you can live a healthy life with only one. Because of that, you might choose to donate a kidney to either a known or unknown recipient. In general, donating a kidney doesn’t affect life expectancy, but there may be other impacts.  Read on to learn more about what’s really involved when it comes to donating a kidney.  

How do you become a living kidney donor?  

To become a donor, you’ll first need to reach out to the hospital treating your friend. Once you express your interest in donating, you’ll gp through a complete medical and psychological evaluation. Medical evaluations ensure that your kidneys are healthy, and that you don’t have any illnesses that can be passed on to your recipient. Psychological evaluations ensure that you don’t have any psychiatric conditions that could impact the donation process.  

There are some limitations on who can become a kidney donor, including:  

• Age: donors usually have to be between 18 and 65 years old, although some hospitals restrict donations to those over 21.  
• Medical or psychiatric illness: including high blood pressure, diabetes, or cancer.  
• Weight: some people with BMIs above 35 may be asked to lose weight. BMI is an imperfect measure, so lifestyle adjustments may be determined by a health care provider.  
• Smoking: including light smoking—though you can donate if you quit for several weeks before the surgery.  
• Alcohol use: Heavy alcohol use can impact kidney health. 
• Contraceptive use: if you take birth control pills, you might be asked to stop taking them for 30 days before the surgery because of the risk of blood clots.  

List adapted from UCSF Medical Center Transplant Service and National Kidney Foundation 

To donate to your friend, you’ll have to have either blood type “O” or the same blood type as them. For kidney donations, it’s not necessary to have the same Rh factor, or the “positive” and “negative” blood type. If you aren’t a compatible match with your friend, their transplant team might be able to arrange a “paired exchange.” You’ll “swap” donors with another incompatible recipient and donor pair so that your friend receives their donor’s kidney, and you donate your kidney to the other recipient.  

If you’re cleared for donation, you’ll be scheduled for surgery where your kidney will most likely be removed through a tiny incision in your stomach area. After surgery, your remaining kidney will grow to meet your body’s needs.  

What are some considerations before becoming a kidney donor?  

Donating a kidney is a major surgery that can take a significant toll on the body. Some aspects of donation that you might want to consider before deciding whether to go forward include:  

• Your financial position: Most of the time, all your medical expenses will be covered by your recipient’s insurance. It likely won’t cover  time off work, childcare, or travel expenses. There are some organizations that can help you cover these costs. However, these organizations don’t often cover recovery time. Therefore, you can financially manage not working for week after surgery, if necessary.  
• Job security: Even if you’re financially stable, you might consider whether your job would allow you to take up to eight weeks off. Alternatively, does your job offer employee benefits like sick time, family leave policies, or remote work options that you could tap into during this time.  
• Recovery time: The minimum recovery time for the surgery is four to six weeks, though some people need as long as twelve weeks. You’ll likely only stay in the hospital for one to two days after the surgery, but you should expect to be on pain medication and have significant discomfort for one to two weeks afterwards. Your transplant team might suggest that you avoid sex for several weeks.  
• Future pregnancy: If you were assigned female at birth (AFAB) and are hoping to become pregnant, your transplant team may recommend that you wait around six months to one year after surgery to become pregnant.  

List adapted from UCSF Medical Center Transplant Service and National Kidney Foundation 

What are some potential risks to donating a kidney?  

The risks of donating a kidney include those posed by any surgery, including blood loss and infection around the surgical area. These include  developing a hernia if you lift anything heavy after the surgery, or a urinary tract infection (UTI) from the catheter used during the procedure.  

Donors have the same life expectancies as non-donors. There is, however, some evidence that pregnancy after donation might come with a higher risk of complications, including hypertension and pre-eclampsia.  

Choosing to donate a kidney is a big decision, but one that could significantly improve the chance that your friend has a healthy future. You might consider reaching out to a health care professional whom you trust to help you make this decision. Organizations like the National Kidney Foundation and the National Kidney Registry could also help you better understand what to expect from the donation process.  

All the best for you and your friend,