Q&A on Living Donation

Table of Contents:

1.
General Information on Living Donation
2.
Where Do I Start?
3.
The Evaluation Process
4.
Making the Decision
5.
Financial and Insurance Issues
6.
The Surgery
7.
What to Expect After Donation
8.
For Transplant Candidates

To print the entire Q & A, click here

 

6. The Surgery

  1. What are the different types of surgery?
  2. What are the risks of surgery?

What are the different types of surgery?

A kidney can be removed in either of two ways, the traditional open surgery or the laparoscopic technique. Your transplant team can provide you with information about the different types of surgery.

Some donors may not be able to have laparoscopic surgery because of previous surgeries or anatomical variations. These variations are generally detected during the testing process, in which the potential donor would be notified that they would not be a candidate for laparoscopic donation.

Some scheduled laparoscopic donations must be converted to the open technique during the surgery process.

Once all the testing has been successfully completed, the operation is scheduled. A general anesthetic is administered in the operating room. Generally, the donor and the recipient are in adjacent operating rooms. The kidney is carefully removed and transplanted into the recipient. Immediately, the donor's single kidney should take over the work previously done by the recipient's two kidneys. Typically, the surgery takes 3-5 hours with time in the recovery room recovery afterward for observation.

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What are the risks of surgery?

It is quite normal for a donor and the donor's family to have fears and concerns about potential complications. This might be felt by some as reluctance to donate, yet it is natural reaction to a major surgery. Potential donors should speak openly with the transplant team about these fears. All conversations between the living donor and the transplant team and the results of medical testing will be kept confidential.

Both laparoscopic and open surgery has different benefits and risks, which potential donors should discuss with the transplant team.

The surgery involves the same level of risk for the donor as any other major surgery. The majority of complications following surgery are minor and may cause a longer hospitalization. The risks associated with surgery and donation should be discussed with your transplant team, and include:

  1. Pain. You will receive medication for pain after the surgery.
  2. Infection. If the wound from the surgical incision becomes infected, it will be treated with antibiotics. An infection can delay the healing process or cause scarring or other problems.
  3. Pneumonia. Surgery increases the risk of developing pneumonia. You will be asked to cough and breathe deeply to decrease your risk of developing pneumonia.
  4. Damage to the Kidney. There is a possibility of damaging the kidney during the surgical procedure. Every attempt will be made to minimize this risk. The surgeon may change a scheduled laparoscopic procedure to the open surgery in order to access the kidney safely.
  5. Blood Clotting. You will be encouraged to move around as soon as you can after surgery. This will stimulate blood circulation to help prevent blood clots.
  6. Collapsed lung. The kidney is close to the lung, and the pleura (the space around the lung) may be inadvertently opened during surgery. If this happens, the lung may collapse. The doctors would then insert a tube into the chest to expand the lung.
  7. Allergic reaction to anesthesia. During the evaluation process, the transplant team will try to identify any allergies you might have. If you have an allergic reaction to anesthesia, the doctor will take immediate action to correct the problem.
  8. Death. For living kidney donors, the risk of death is about 0.06% (about 1 death for every 1,700 procedures).

Living Kidney Donor Laparoscopic Surgery

Here is a graphic video of a real living kidney donor laparoscopic surgery. This video is from Medline Plus, courtesy of Sentara Norfolk General Hospital in Norfolk, VA and Medline Plus, US National Library of Medicine and the National Institutes of Health. A question and Answer period about living donation follows that includes information about the recipient, living donor and surgery.

To find out if your state has authorized paid leave for living donation for state employees and or tax credits for living donors look at: Donor Leave Laws and Tax Deductions/Credits for Living Donors

 

 

Click here for detailed statistics on short-term complications from living donation (as reported to the United Network for Organ Sharing).

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