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Living Donor Kidney Transplants

Family members or friends often offer to donate a kidney to a patient in need, and this is the most commonly performed type of living organ donation. There is little risk to the donor, because the remaining kidney enlarges to absorb the workload that both kidneys previously shared. Organ transplantation may enhance or extend the life of a loved one, but transplantation is not a cure.

The primary advantages of living kidney donation are that:

  • recipients receive a transplant far sooner than is possible by waiting on the list for a deceased donor kidney, and
  • there is a higher success rate after transplantation.


In this series of videos, Sandip Kapur, M.D., the Chief of Transplant Surgery and Director of Kidney and Pancreas Transplant Programs at NewYork-Presbyterian Hospital/Weill Cornell, discusses living donor kidney transplants. (Dr. Kapur's profile)

Who Can Donate?

Compatible live donor transplants (in which blood type and genetic make-up between donor and recipient match well) are the gold standard of kidney transplant procedures. Potential kidney donors must undergo extensive testing and interviews to determine eligibility to donate.

Potential kidney donors must be:

  • from 18 years of age into their 70s
  • in overall good health
  • preferably immunologically compatible with the recipient
  • free of diseases such as cancer, HIV, or hepatitis C

Donors may be blood relatives of the recipient, or they may be unrelated. Better genetic and immunologic matches help reduce the risk of organ rejection. A kidney from a perfectly matched sibling donor can function for an average of 35 years, while less perfectly matched kidneys function for 20 years on average.

The Independent Donor Advocate Team

Anyone considering kidney donation will work with the Hospital's Independent Donor Advocate Team, a group dedicated to the health and well-being of potential live donors. Members of the team will help potential donors learn about the procedure and determine whether donation is the best decision for himself or herself.

The Independent Donor Advocate Team consists of:

  • a nephrologist (kidney specialist),
  • surgeon,
  • transplant coordinator,
  • social worker,
  • and psychiatrist.

Members of this group advocate solely for donors and act completely independently of the needs of recipients.

Important Points to Consider

In a three-year survey of organ donors at NewYork-Presbyterian, 93% said they would do it again. But the decision to donate an organ must be the right one for the donor. Potential donors should know that they may decide not to donate at any time during the process – it is never too late to back out.

Financial assistance is available from the National Living Donor Assistance Center (NLDAC) to those who want to donate an organ, and otherwise would not be able to afford the costs of travel, lodging, and meals associated with evaluation, surgery, and recovery.

The Procedure

Some centers remove a donor's kidney using conventional surgical procedures with an open incision, but all kidney removal procedures (nephrectomies) at NewYork-Presbyterian are performed in a minimally invasive fashion using laparoscopic surgery. For anatomical reasons, the left kidney is usually removed for transplantation. Surgeons perform the procedure using tiny instruments that are inserted into three or four small incisions, called ports, in the abdomen. The laparoscopic technique benefits donors by significantly reducing:

  • post-operative pain,
  • scarring,
  • and shortening recovery times: on average, kidney donors spend two days in the hospital and can return to their normal activities within three weeks.

Risks to the donor are small and manageable, but include pain, infection, pneumonia, blood clotting, collapsed lung, and allergic reaction to anesthesia. The risk of death is extremely low – 3 in every 10,000 procedures – which is a lower risk than driving to work each day. Donating a kidney will not prevent donors from becoming pregnant or from fathering a child.

Paired Kidney Exchanges

Increasingly, the arrangement of paired exchanges, or "donor swaps," is facilitating transplants where matches would not have been possible. A paired exchange consists of two (or more) kidney/donor recipient pairs whose blood types are not compatible or when the recipient has antibodies against their donor. The recipients trade donors so that each recipient can receive a kidney with a compatible blood type.

The transplant programs of NewYork-Presbyterian are national leaders in the performance of multiple paired living donor kidney transplantation. Since 2004, the Hospital has performed many two-way swaps, which require four simultaneous operations, as well as several three-way, four-way, and even a six-way exchange. These arrangements allow some patients to receive a transplant who otherwise would not have had a compatible donor.

The Hospital also pioneered the Never Ending Altruistic Donor (NEAD) Chain, in which one altruistic living kidney donor, willing to donate to any patient awaiting transplantation, begins a chain of kidney transplants that otherwise would not be possible.

Contact

NewYork-Presbyterian/
Columbia
Renal and Pancreatic Transplant Program
Directions
(212) 305-6469
NewYork-Presbyterian/
Weill Cornell
Kidney and Pancreas Transplant Programs
Directions
(212) 746-3099
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