Becoming a living kidney donor
WHO CAN DO IT?
After you decide that you would like to be considered as a kidney donor, there are a number of tests and investigations needed to make sure you are healthy enough to give a kidney, that your kidneys are currently working well, and that you are physically and emotionally ready for the donation.
Being a healthy person is not the same as being a suitable donor. For example, you may have been born with one kidney, and only discover this when you put yourself forward for tests. This would obviously prevent you donating a kidney, but it does not mean that you are not healthy.
Each transplant centre across the UK has its own list of tests for potential donors. These are based on nationally agreed guidelines and can involve urine and blood tests, blood pressure monitoring, scans, a chest X-ray, and heart tracing. How these tests are done can vary, however your healthcare professional will always discuss these with you before you begin, to make sure you are comfortable.
HOW DOES IT WORK?
Warning: Contains description of medical tests and surgery
After your initial health checks, more tests are done to discover your tissue type and blood group. If your kidney donation is directed to a named recipient, this will be done at an early stage to check if you are a match. If you are a non-directed donor, these may be done after the initial health checks to help match you with the right recipient on the waiting list.
During this process, blood will also be taken from both you and the recipient to check if the recipient has antibodies that might react against your donated kidney. If there are antibodies to the donor kidney, another recipient may be chosen to receive your kidney. If your donation is directed, you may still be able to donate and help your chosen recipient through the UK Living Kidney Sharing Scheme.
FINAL CHECKS
The final preparation stage involves meeting with an independent assessor. These assessors are trained by the regulatory body, the Human Tissue Authority (HTA), as part of the legal process needed to donate a kidney. They want to find out if the person who is offering to donate a kidney completely understands the implications and risks of the process and is making an informed decision to donate their kidney. They must also be sure that the potential donor is not being either bribed or coerced into donating.
In the week or fortnight before the operation, a few of the blood tests may be repeated to make sure nothing has changed. Some routine “pre-op” (before the operation) investigations may also be done during a pre-admission visit to the hospital.
The process above may seem daunting and time consuming. However, the priority is always to make sure donation is as safe as possible for the donor. All of the above will usually be completed within several months.
THE OPERATION ITSELF
Surgery to remove a kidney is a major operation that requires a general anaesthetic. This means that you will be asleep during the operation, which normally takes around two to three hours.
A kidney is usually removed using keyhole (or “laparoscopic”) surgery. This involves a number of small incisions (1–3 cm each). A larger incision is also made to take the kidney out. Some centres now use robotic equipment to help them during surgery. Your surgeon will explain this when you meet to discuss the operation.
DID YOU KNOW?
Traditionally, surgeons used a technique called open nephrectomy to remove a kidney. This involved making a 15–20cm cut in the side of the abdomen. Nowadays, this technique has mostly been replaced by keyhole surgery, which has a shorter recovery time and more discreet scars.
HOW SAFE IS LIVING KIDNEY DONATION?
One of the most frequently asked questions is “How safe is it to donate a kidney?”. Donor safety is a top priority. Regardless of the need for kidneys, donation is not acceptable if the donor is put at excessive risk of harm, so every effort is always made to minimise the chance of any problems.
However, it is important to understand that donation is not risk-free. Your healthcare team will discuss the main risks for you, based on your medical history or demographic, as risk must be considered based upon your individual circumstances. It is also important to remember that research in this area is always evolving, and it is not possible to cover every possibility. Not every consequence of donation has been fully researched yet.
WHAT ARE THE CHANCES OF SUCCESS?
Living kidney transplantation is usually very successful, with 96 per cent of donated kidneys working well a year after the operation. This compares with a success rate of 93 per cent for kidneys from deceased donors.
However, there is sadly no guarantee that the transplant will be successful. A small number of recipients have very serious complications which result in the new kidney being removed. Before agreeing to be a donor, it is important to consider how you might feel if the transplant is not successful.
HOW WILL DONATING A KIDNEY AFFECT ME?
Healthy people who wish to help a loved one or a stranger with kidney disease may volunteer to give a kidney. Volunteer is an important word here – this must be something that you choose to do and feel comfortable doing.
Deciding that you would be interested in donating a kidney is a big decision. It is important that, before you make your mind up, you understand how this decision will affect you and the risks involved in donating.
You can read more about living with one kidney here.
