Although much of the preliminary process for a living donor is similar to that of the transplant recipient, there are unique elements that are specific to living donation particularly regarding the surgery and post-surgery care. The following are frequently asked questions that may not have been covered elsewhere on this web site:
All clinic, hospital, and reasonable physician's charges from donor evaluation are covered by the Medicare End-Stage Renal Disease Program, whether or not the donor is accepted. You can discuss any questions, at any time, with the Transplant Program's financial coordinator.
As a living donor, you should be aware of the financial aspects of donation. Donors should check with their own insurance prior to donation. Although unlikely, the act of donating a kidney could possibly affect future insurance coverage. We recommend that you have insurance prior to donating a kidney. Some aspects of the donation may be covered by the Transplant Recipient's insurance.
Items typically covered by the Transplant Recipient's insurance:
Items typically NOT covered by the Transplant Recipient's insurance:
*For travel expenses and other funds, the National Living Donor Assistance Center (NLDAC) offers a grant to donors. However, there are income qualifications that both the donor and the recipient must meet in order for the donor to be eligible.
Patients are admitted the day of surgery. Pre-operative testing will be performed approximately 7-10 days before admission to make sure the donor is still in good health. A member of the Transplant Team will also meet with the donor prior to admission. Once admitted to the hospital, the donor will have another opportunity to discuss final concerns with a provider.
Surgery is usually scheduled early in the morning, lasts about three hours and is performed under general anesthesia. There are two surgical options: laparoscopic or open nephrectomy, which will be discussed in detail during your evaluation. Once the kidney is removed, it is immediately transplanted into the recipient. The donor's remaining kidney then takes over the work previously done by two kidneys. After the surgery, the donor is moved to the recovery room for observation, then returned to a hospital room when fully awake.
This depends on the donor's surgical procedure: for a laparoscopic kidney removal the hospital stay is 2–3 days; for an open nephrectomy procedure the hospital stay is 4–5 days. At the time of discharge, a follow-up appointment will be scheduled.
Immediately after the surgery, the donor can expect to be tired from the operation and anesthesia and will experience pain from the incision. Medication will be given to relieve the discomfort, which will decrease as the donor becomes more active. Usually pain medicine is not needed after the first week or two. As the incision heals, the pain will become less severe, but tenderness, tingling, and itching may continue for a number of weeks.
Pain medication may be necessary for several days after discharge, but no other medicine is routinely needed, and no long-term diet changes are necessary.
Laparoscopic kidney donors tend to return to work in 4-6 weeks, while open nephrectomy kidney donors return to work in 6–8 weeks. Restrictions will be discussed based on the type of procedure performed. Generally, sexual activity can be resumed in one to two weeks after discharge from the hospital. There are no long-term restrictions on physical activities, except for contact sports, which could injure the remaining kidney.
There will be a 6 month, 1 year and 2 year follow-up with the transplant team. We recommend that all kidney donors see their primary care doctor once a year for routine checkups. This annual visit should as a minimum include a physical, blood-pressure check, urinalysis, and basic blood tests. It is extremely important for living donors to pursue a healthy life style for the long term (getting regular exercise and maintaining a healthy weight) to minimize the risk of hypertension (high blood pressure) and diabetes.