Frequently Asked Questions

When initially considering living kidney donation, one may consider the question of how or why the medical profession would allow someone to undergo surgery to donate a kidney to give to someone else in need of a transplant.

Many studies have been performed to assess the risks of kidney donation on the people who made the choice to become a donor. 

The majority of studies have found that:

• The risk to a donor's physical health is minimal in both the short-term (surrounding the surgery) and long-term (in terms of kidney function, high blood pressure, and the donors lifespan).

• Kidney donors tend to have higher quality of life scores after donation, as compared to the general population.

• Donors have similar or improved psychosocial health after donation.

• The overwhelming majority of donors would choose to donate again.

The Basic Principles of Living Kidney Donation

1. The prospective living organ donor should be:

• Capable of making the decision to donate

• Willing to donate

• Free of coercion, manipulation, or undue solicitation by any party regarding the decision to donate

• Medically suitable to donate

• Psychosocially suitable to donate, based on an evaluation that includes a series of specific components

• Fully informed of the risks and benefits to the donor, as demonstrated by the donor's expression of understanding of these risks and benefits

• Fully informed of the risks, benefit and alternative treatment available to the recipient, within the constraints of the transplant center's obligation to maintain the confidentiality of recipient medical information

• Willing to sign a statement attesting that the donor is not providing the organ for monetary gain

2. The prospective live organ donor should not be called upon to donate in clinically hopeless situations

3. The benefits to both the donor and recipient should outweigh the risks associated with the donation and transplantation of the living donor organ

4. Medical and psychosocial follow-up of the living donor after donation should be undertaken by the living donor program

from Guidelines for the Psychosocial Evaluation of Living Unrelated Kidney Donors in the United States (Dew MA et al, Am J Transplant 2007; 7(5):1047)

The answer to this question varies from center to center. Some transplant centers will not allow active smokers to donate, while others will. In either case, becoming a kidney donor can be an important impetus to assist you in quitting, and some transplant centers will assist you in this endeavor. 

The concern is related to an increased risk of pulmonary, cardiovascular, and wound healing complications that is seen in the general population of smokers undergoing anesthesia.

Although kidney donors represent healthy people undergoing surgery, and therefore the risk of complications is likely not as high, it is still important to take smoking status into consideration. 

There is little data specific to the population of people undergoing donor nephrectomy. One study found an increased risk of wound complications in donors who smoke, while another study found no difference in complications surrounding the surgery.

At Weill Cornell Medicine and NewYork-Presbyterian, we strongly advise potential donors to stop smoking at least four weeks prior to their scheduled surgery.

The answer to this question depends on your individual situation.

If you have someone specific that you want to donate to, you should contact the transplant center where your intended recipient is being evaluated and/or is on the waiting list for a kidney transplant. The transplant center will then refer you to the donor team responsible for evaluating potential donors, and they will explain what your next steps are.

If you are interested in being an altruistic donor, that is, you want to donate a kidney but do not have a specific recipient in mind, you can contact one of several organizations that registers people who are interested in serving as an altruistic donor, such as the National Kidney Registry or the OPTN Kidney Paired Donation Pilot Program. You can also contact a local transplant center near your home and ask to speak with someone on the donor team.

The evaluation process involves both a psychosocial and medical component.

The psychosocial evaluation is performed by a psychiatrist, psychologist, or social worker, and addresses issues such as motivation guiding decision to donate, ability to understand the risks of donation, availability of support during the recovery period after donation, financial impact of donation, impact of donation on insurability, and other important issues.

The medical aspect of the evaluation process ensures that the potential donor is healthy enough to donate and not at high risk for developing diseases that could impact the function of their remaining kidney. Components of the medical evaluation include general medical history, social history, physical exam, kidney-focused exam, general laboratory tests, kidney-focused laboratory tests, immunological testing (blood type and crossmatch compatibility), metabolic-focused testing (to look for issues such as diabetes or high cholesterol), anatomic assessment of the kidneys and their blood flow, screening for transmissible diseases (such as HIV and hepatitis), and cancer screening.

There are several options that are available if a potential donor is not compatible with their intended recipient.

If available, the person needing a kidney could bring other donors forward to be tested to see if a match can be found.

Another option is to sign up to participate in a Kidney Paired Donation program, where you and your intended recipient would enter a registry of other incompatible pairs in hopes of being matched to someone with whom you are compatible, while your intended recipient receives a transplant from another donor within the registry.

For many donors, the benefit of donating a kidney is often personal one. Each donor's motivations may vary greatly and each donor has a unique experience as they go through the journey of donating their kidney, from the initial decision to be evaluated as a potential donor to years after the donation occurs. 

Key findings of various research studies that have attempted to quantify the benefits and/or quality of life after kidney donation include:

• Kidney donors tend to have higher quality of life scores after donation, as compared to the general population.

• This may be related to an increase in the donor's self-esteem and an increased sense of well-being

• Donors have similar or improved psychosocial health after donation.

The intense screening process that donors must undergo has also helped some potential donors discover serious health issues that require medical attention. At times, screening has led to early detection of kidney disease, high blood pressure, diabetes, and cardiac disease, which can benefit from early diagnosis and intervention.

The operation to remove your kidney does involve risk, since you are undergoing surgery requiring general anesthesia, similar to any other laparoscopic surgery (such as removal of your gallbladder).

These risks include pain, infection, blood clots, reaction to anesthesia, conversion to open nephrectomy, need for re-operation, need for re-admission to the hospital, hernia development, intestinal obstruction, and death.

Please visit the Risks and Benefits of Living Kidney Donation section to see a detailed description of the potential complications of this procedure.

Using today's surgical techniques (conventional laparoscopic or single site surgery), most donors are in the hospital for approximately two days.

The morning after the surgery, the bladder catheter placed during the surgery is removed, you begin to walk around, and you are placed on a clear liquid diet. On the second morning, most patients receive solid food, and are discharged home later in the day.

The answer to this question depends on the type of work that you do. People who work in an office setting usually return to work in 2 to 3 weeks, while people with more physically demanding jobs may need to recover 4 to 6 weeks before returning to work.

Kidney donation should not impact your lifestyle. Since kidney donors are healthy and generally have good health habits, it is recommended to continue to maintain a healthy lifestyle by eating a healthy diet, exercising, not smoking, etc.

Please visit the "Maintaining Health After Donation" section of the Life After Donation page for more information.

Yes, female donors can become pregnant after donating a kidney. It is generally recommended that female kidney donors wait at least 6 to 12 months after donation to become pregnant. In addition, the kidney donation should be discussed with the physician managing the potential pregnancy.

Although the outcomes of pregnancy after kidney donation appears to be similar to that of the general population, some studies have shown that there may be an increased risk of preeclampsia/high blood pressure in women who previously donated a kidney. This is why it is important for female donors to discuss their kidney donation with their obstetrician/gynecologist. 

The current national policy is that former donors who require a transplant themselves at a future time are given 4 extra points on the waiting list, which will help them to move up on the list. This extra waiting time only applies to the wait for a kidney, not any other organ that a former kidney donor might need in the future. 

Yes, the insurance coverage provided by the recipient's insurance works the same way. Any logistics related to the insurance coverage (for example, if the donor is being worked up at a different transplant center than the recipient) are managed by the transplant centers.

In some cases, having been a kidney donor can impact the donor's ability to obtain both health insurance and life insurance. Therefore, it is highly recommended that people considering donation obtain these types of insurance prior to becoming a donor.