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Pregnancy and living kidney donation

An image of two kidneys

Many people thinking about living kidney donation also have questions about pregnancy. Will donating affect your chances of having children? Can you donate while pregnant, or shortly after? And what does pregnancy look like for someone living with one kidney?  

The reassuring news is that, for most people, living kidney donation does not affect a woman’s ability to have children in the future. What matters is timing, good antenatal care, and an open conversation with your transplant team. This page walks you through what to expect before, during, and after pregnancy. 

Can you donate a kidney while pregnant? 

No, living kidney donation is not carried out during pregnancy. When you are pregnant, your body needs to manage the extra work of carrying a baby. Blood volume increases significantly, and your kidneys filter more fluid and waste than usual. Going through major surgery during this time would not be safe for you or your baby, so transplant teams always wait until a safe time after pregnancy before considering donation. 

If you are currently pregnant and thinking about donating in the future, you can still learn more, ask questions, and register your interest now. The assessment and surgery itself would simply happen further down the line. 

Can you have a baby after donating a kidney? 

Yes. Most people who donate a kidney go on to have healthy pregnancies. Transplant teams usually recommend waiting until you have fully recovered from the donation before trying to conceive. In most cases this means waiting a period of time after donation, although the right timing varies depending on your individual recovery and your overall health. 

This waiting period gives your remaining kidney time to adjust and take on the work previously done by both kidneys. Once your follow-up checks are reassuring, pregnancy is generally considered safe. 

If you would like to talk through what timing might look like for you, the best place to start is to get in touch with our team, or speak to your transplant coordinator. 

Getting pregnant after donating a kidney 

Most donors who become pregnant after donation have healthy, straightforward pregnancies, and most go on to have healthy babies. 

That said, studies have shown a slightly higher risk of two pregnancy-related conditions in donors compared to women who have not donated: 

  • Gestational hypertension (high blood pressure that develops during pregnancy) 
  • Pre-eclampsia (a condition involving high blood pressure and signs of organ stress, usually appearing after 20 weeks of pregnancy) 

In the largest study to date, gestational hypertension or pre-eclampsia affected around 11% of pregnancies in donors, compared to around 5% in matched non-donors. The overall numbers are still low, and both conditions are well understood and manageable with proper antenatal care. 

If you become pregnant after donating, your midwife and obstetric team will usually monitor your blood pressure and urine more closely as a precaution. It is also helpful to let your antenatal team know early in pregnancy that you are a living kidney donor, so they can plan your care accordingly. 

Risks for babies born to a living kidney donor 

The risks and outcomes for babies born after the mother has donated a kidney are comparable to pregnancies from people who didn’t donate a kidney. Even if there is pre-eclampsia during pregnancy, the outcomes for the baby are still comparable. 

Risks for women considering kidney donation 

Donating a kidney does not affect fertility in men or women and the vast majority of people who donate go on to live full, normal lives. There are a few factors that your transplant team will want to talk through with you, including:

A slightly higher risk of high blood pressure during future pregnancies 

The need for closer antenatal monitoring in any future pregnancy 

Long-term kidney function with one kidney 

The value of regular blood pressure checks throughout the rest of your life 

These are not reasons to rule out living kidney donation, but they are important to understand. The transplant team will look at your individual health, your age, and your future plans as part of the assessment, and explain what these factors mean for you personally. 

For broader information about what donating a kidney involves, please see our page on the risks of donating a kidney. 

What your transplant team will discuss with you 

If you are of childbearing age, the transplant team will want to talk through your family plans as part of the assessment. This is not to put you off donating. It is simply to make sure you have all the information you need to make a confident, informed decision. These conversations usually cover: 

Whether you plan to have children, now or in the future 

How long to wait before trying to conceive after donation 

What antenatal care will look like in future pregnancies 

Long-term follow-up after donation, including blood pressure monitoring 

Any specific concerns you have about your own health or family history 

Your future plans are taken seriously and are part of the wider donation decision. You will never be pressured into a particular choice, and you have the right to change your mind at any point in the process. 

Frequently asked questions 

Can you have a baby after donating a kidney? 

Yes. Most people who donate a kidney go on to have healthy pregnancies. Transplant teams usually recommend waiting for some time after surgery to give your body time to recover and your remaining kidney time to adjust. 

Does having one kidney affect fertility? 

No. Donating a kidney does not affect your ability to conceive. There is no evidence that having one kidney makes it harder to get pregnant. 

Will pregnancy damage my remaining kidney? 

For most donors, no. The slightly increased risks during pregnancy relate to blood pressure rather than long-term kidney damage. With good antenatal care, pregnancy after donation is generally considered safe, and most donors continue to live healthy lives afterwards. 

Can you donate a kidney while breastfeeding? 

Donation is usually delayed until breastfeeding has ended, so that your body has fully recovered from pregnancy and birth before going through surgery. Your transplant team will talk through the right timing with you. 

Support and next steps 

If you are thinking about donating and have questions about pregnancy, family planning, or anything else, we would love to hear from you. Our buddy support service can connect you with someone who has lived experience of living kidney donation, including women who have been through pregnancy after donating. 

Sources 

  1. NHS Organ Donation – Kidney donation, pregnancy and fertility 

https://www.organdonation.nhs.uk/become-a-living-donor/donating-your-kidney/kidney-donor-health-considerations/kidney-donation-pregnancy-and-fertility/ 

UK patient-facing guidance on pregnancy, fertility and antenatal monitoring after donation. 

  1. Garg AX et al., Gestational Hypertension and Preeclampsia in Living Kidney Donors, New England Journal of Medicine, 2015

https://www.nejm.org/doi/full/10.1056/NEJMoa1408932 

Source of the 11% vs 5% pre-eclampsia / gestational hypertension figures. 

  1. British Transplantation Society / Renal Association – UK Guidelines for Living Donor Kidney Transplantation (2018)

https://bts.org.uk/wp-content/uploads/2018/07/FINAL_LDKT-guidelines_June-2018.pdf 

UK clinical guideline – position that future pregnancy plans alone shouldn’t exclude donation. 

  1. van Buren MC et al., Pregnancy after living kidney donation: a systematic review, American Journal of Transplantation, 2022

https://pmc.ncbi.nlm.nih.gov/articles/PMC9804926/ 

Confirms the risk pattern is consistent across studies and absolute risks remain low. 

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