Living Donor Surgery

What does the operation involve?

In general, you will be given a general anesthetic in the operating room. You will be asleep and will not feel any pain during the surgery. In most cases, you and your recipient will be in adjacent operating rooms. One of your kidneys will be carefully removed and transplanted in the recipient. Typically, the surgery takes 3–5 hours with time in the recovery room afterward for observation. Removing your kidney may be done by laparoscopy or open surgery. The surgery to remove a kidney is called a “nephrectomy.”
 

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.
 
Laparoscopy is the preferred method for kidney donor transplants. It involves the use of a laparoscope (wand-like camera) that is passed through a series of small incisions or “ports” in the abdominal wall (stomach). It is used to view the abdominal cavity and remove the kidney through a small incision. The advantages of laparoscopic surgery include shorter recovery time, shorter hospital stay, smaller incisions, and fewer post-operative complications. Laparoscopic surgery takes special skills to perform and is not available at all hospitals. Also, whether you can have laparoscopic surgery depends on your medical condition and overall health.
 
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.
 
Open nephrectomy is also done under general anesthesia and is a more invasive procedure. The surgeon makes a cut (incision) in the abdomen or in the side of the abdomen. A rib may need to be removed to perform this procedure. After the kidney is removed, the incision is closed with stitches.
Your transplant center can give you the most current medical information about the surgical process. They will help you determine what is best for you.

What should I do if I have concerns about surgery?

It is quite normal for you and your family to have some fears about the operation and possible complications. You should speak openly with your transplant team about any fears or concerns you have. You should also learn the risks of surgery in addition to long term risks of living donation.  All conversations between you and the transplant team will be kept confidential. The results of your medical tests will also be kept confidential.

How long will I need to recover?

This depends on which type of surgery you have, but most people are in the hospital three to seven days after surgery. However, everyone is different and the rate of recovery will vary greatly among individuals. Ask your transplant center for their best estimate of your recovery time.
After leaving the hospital, most people will feel tenderness, itching, and some pain as the incision heals. Most kidney donors can return to normal activities after four to six weeks, depending on the physical demands of their daily living and work tasks. Heavy lifting should be avoided for about six weeks following surgery. You may not be able to drive for up to two weeks.
 
Make sure to see your primary care practitioner regularly for follow-up care, and have your urine, blood pressure, and kidney function (GFR) checked yearly.
 
***Please note this video is graphic as it is 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.
 
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About NKF Cares
NKF Cares is a free, confidential hotline with trained professionals ready to answer your questions or concerns. Our peer-mentoring program, NKF PEERS, connects anyone affected by kidney disease with an informed and supportive mentor who has already been through the process.