Q&A on Living Donation

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How can I be a living kidney donor to someone I know?

To donate a kidney, you must be in good health and have normal kidney function and anatomy.

If the donor meets the criteria for donation, additional testing will be required to check for further compatibility (cross matching and tissue typing) as well as physical examinations and psychological evaluation. More information on testing and surgery procedures can be found in this booklet.

The donor should make the decision voluntarily and free from internal or family pressure. The decision to donate needs to be made with all the information necessary to make an informed, educated choice.

Immunosuppressive medications, which keep the recipient's body from rejecting the donor kidney, have improved greatly over the last few years. Now, a genetic link between the donor and recipient does not appear to be necessary to ensure a successful transplant.

Before surgery, the donor will receive education and counseling to help prepare mentally and emotionally for the donation and recovery. If the donor has questions, the transplant team can help. The decision to donate will affect all members of the person's family and should not be taken lightly.

Your first step is to contact the potential recipient's transplant center. (Transplant centers are hospitals that perform transplant operations-and donor operations, if there is a living donor). You should ask to speak with the Kidney Transplant Coordinator, who can give you additional information about living donation, and help you get started. If you live far away from the transplant center, you'll be referred to a center in your area for initial testing.

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I want to be a donor to a friend or family member, but they won't let me. What can I do?

Some individuals with kidney failure may decide they do not want the transplant or choose not to consider a living donor. The person with kidney failure can choose to accept or reject your offer to donate. He or she has the right to decide against a transplant (though you may feel it would help). The patient, who must live with the disease, has the right to decide what is to be done. That decision, as well as yours, must be respected.

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What are the long-term risks of donation?

You will also have a scar from the donor operation- the size and location of the scar will depend on the type of operation you have.

Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction. There are not currently any national statistics on the frequency of these problems.

In addition, people with one kidney may be at a greater risk of:

• High blood pressure
• Proteinuria
• Reduced kidney function

For more information, visit the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) website at http://kidney.niddk.nih.gov/kudiseases/pubs/solitarykidney

You should discuss these risks with your transplant team, and ask for the hospital for any statistics related to these problems.

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What else can I do?

You may not be able to be a living donor- or you may decide that living donation isn't right for you. You can still help those awaiting life-saving organ transplants. Here are a few ways you can make a difference.

1. Be a Donor after Death: Learn more at http://www.kidney.org/transplantation/beadonor.cfm
2. Donate blood or bone marrow: Blood and bone marrow donations save lives every day. For more information about blood donation, call the American Red Cross at (800) GIVE LIFE, or visit www.redcross.org.
   
   For information about bone marrow or blood stem cell donation, contact the National Marrow Donor Program at (800) MARROW2 or at www.marrow.org.
3. Volunteer or make a donation: Contact the NKF at (800) 622-9010 to make a donation, or for information about NKF offices in your area. Your local NKF office can provide you with information about any volunteer opportunities in your area.

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Who pays for living donation?

The cost of the living donor's evaluation, testing and surgery are generally paid for by the recipient's Medicare or private health insurance, if the donation is to a family member or friend. Donors should always coordinate their tests with the transplant coordinator at the hospital in case there are any exceptions.

Time off from work and travel expenses are not covered by Medicare or private insurance. However, donors may be eligible for sick leave, state disability and the Family and Medical Leave Act (FMLA). Some follow-up expenses may also not be covered, so it's important to discuss these matters with the transplant center. The financial counselor at the transplant center can answer any questions you have about the cost of donation.

You can also request a free Q&A from the United Network for Organ Sharing entitled "What Every Patient Needs to Know." The booklet has an extensive section on financial issues for both donors and recipients, including social services, insurance coverage, Medicare and Medicaid coverage, fund raising campaigns and other possible sources of assistance. Call UNOS toll-free at 888-894-6361 to request a copy.

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