Q&A on Living Donation

Table of Contents:

General Information on Living Donation
Where Do I Start?
The Evaluation Process
Making the Decision
Financial and Insurance Issues
The Surgery
What to Expect After Donation
For Transplant Candidates

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4. Making the Decision

  1. What do I need to think about before donating?
  2. What if I decide against being a living donor?

What do I need to think about before donating?

Living donation is a big decision, so you should make sure you're comfortable with your choice. Consider all the information in this booklet carefully, as well as information from your transplant center. Talk to your family members and friends. Some donors also find it helpful to consult with co-workers, a psychologist, social worker, or spiritual advisor.

Your transplant center will have a social worker who can help you with the process. The social worker is there to assist you, and will keep your discussions confidential.

Potential donors should consider the following questions:

  1. How do you feel about organ donation in general? How much education and information do you have about the process?
  2. What are the benefits and risks of donation to you personally?
  3. How would living donation affect you financially? Would you lose wages during your recovery? Are you able to get paid leave from your employer? Are you retired or currently unemployed, so that lost wages wouldn't be a factor?
  4. Who else can be considered as a donor? Other potential donors should consider these issues, as well.
  5. Are you physically active? It's recommended that kidney donors avoid sports that involve high risks of collision, to avoid damaging the remaining kidney (such as boxing, field hockey, martial arts…). Do you have a physically demanding job?
  6. How is your relationship with the recipient? If the donor and recipient have a difficult relationship, some donors may have unrealistic expectations that the relationship might improve.

    How will you feel if the organ fails? How will you feel if the recipient is not grateful in the way you imagined? If the relationship becomes strained or difficult, can you cope?
  7. Are you able to handle post-operative pain, a bout of depression, anxiety? Are you prepared emotionally and financially to seek psychological counseling or help if you need it? Can you handle a complication that may delay your recovery?
  8. Do you live near the recipient and the transplant center where the donation would take place? If the donor lives near the transplant center, the donation will be logistically easier-- and save travel, lodging and other expenses.
  9. What other obligations do you have (such as a demanding job, volunteer commitments, young children, etc.)? How will you manage these obligations during your recovery?
  10. Do you smoke? If so, you might have to quit smoking prior to the donation.
  11. Are you overweight? If so, you might need to lose weight prior to the donation.
  12. Do you have plans to change occupations soon? If so, how would donation affect your health insurance coverage? Life insurance? Some branches of the military, police and fire departments won't accept individuals with one kidney. If any of you are in these fields (or considering these fields), you should think carefully about how living donation might affect you.
  13. Who can support you (both in emotional and practical ways) during this process?

Potential donors will need to consider their overall health, any medical problems such as high blood pressure or diabetes, level of activity, the effects of donation on children or other family members, financial considerations, time lost from work, travel expenses, and the donor's distance from the transplant center.

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What if I decide against being a living donor?

The decision to become a living donor must be made voluntarily and free from pressure. Individuals have the right to decide that kidney donation is not for them. Likewise, some individuals with kidney failure may decide they do not want a transplant or choose not to consider a living donor. The decision of the potential donor and recipient must be respected. Living donors may change their minds at any time during the evaluation process without fear of embarrassment or repercussions:

There may be instances… in which the potential donor seeks the support of the transplant team to decline donation. For example, if the potential donor anticipates being ostracized from the family by saying "no" to the recipient, the transplant team could assist the potential donor in developing an appropriate medical disclaimer, enabling the potential donor to decline gracefully…

-- The Authors for the Live Organ Donor Consensus Group, "Consensus Statement on the Live Organ Donor", JAMA, December 13, 2000- Vol 284, No. 22 (Reprinted)

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