Living Donor Kidney Program

The need for kidney donation, whether deceased or living, is as great now as ever. With a significant shortage in organs available for transplantation living donation continues to be imperative in helping to close the gap and save lives.

Living kidney donation is emerging as the preferred means of donation because of the following benefits:

• The quality of the donated organ tends to be superior to deceased organs because they last nearly twice as long as kidneys transplanted from deceased donors.
• The waiting time for a transplant recipient can be significantly reduced.
• The procedure can be scheduled at a time convenient for both the donor and recipient.
• The time between removing the kidney and transplantation to the recipient is less.
• There is less rejection and fewer or lower doses of anti-rejection medication needed for the organ recipient.

Who Donates?

There are different types of living donors. There are four types of living donations:

• Living Related Donation (LRD): the living donor is a blood relative (such as a parent, child, sibling etc).
• Living Unrelated Donation (LURD): the living donor who is not a blood relative (such as a spouse, friend, or co-worker).
• Living Non-Directed Donation (NDD): the living donor does not direct the donation to a specific individual, but rather to the most compatible person on the waitlist. This form of donation is also sometimes called “anonymous” donation because the donor and recipient do not know each other
• Paired Donation: matches best compatible donor/recipient pairs (see diagram below).

Living Kidney Donation: What you need to know

Living Donor Process

A living donor should be at minimum:

• 18 years of age or older
• In good mental and physical health
• Voluntarily willing and fully prepared to undertake the donation process

Potential donors are required to complete the donor evaluation process. Every potential donor is evaluated on an individual basis.

Where to begin:

If you are interested in becoming a living donor, you should contact the Living Donor Kidney Program at 801-585-3202 to request a questionnaire. Once the questionnaire has been completed it will be reviewed by a nurse coordinator to determine if you may proceed with initial blood testing. A questionnaire can also be printed from the FORMS button on the left or by calling the Living Donor Kidney Program. Questionnaires should be mailed or faxed to the following address:

Attn: Living Kidney Donor Coordinator
University of Utah – Solid Organ Transplant
30 N. 1900 E. RM AC144
Salt Lake City, UT 84132
Fax to: 801-585-6373

Blood testing:

The next step is to determine your blood type. There are four blood types A, B, AB, and O. If you have a blood type that is not compatible with your intended recipient, you and your intended recipient may be referred to our Paired Donation Program to assist in finding another donor/recipient pair(s) to exchange to allow the donation process to proceed. To find out more about our Paired Donation Program click here.

The blood type is determined by drawing your blood and testing it. After test results are back, if appropriate you will proceed to evaluation.

Evaluation:

After initial assessment and blood testing, if determined appropriate, you will go through an in-depth assessment of your health. The health of our donors is of utmost importance to our transplant team. What we need to ensure is that:

• Your blood type and tissue antigens are compatible match with the recipient’s.
• You are healthy (physically, mentally, and emotionally) enough to withstand major surgery and recover completely.
• You have a healthy kidney to donate

The in-depth assessment will include a complete medical history, a physical, a series of laboratory and x-ray tests, and other testing as necessary for medical clearance and evaluation. Additional tests may be necessary depending on the results of these studies.

Once evaluation testing is complete, the results will be reviewed by a multidisciplinary committee who decides whether you are able to safely proceed with the donation. You will be notified of the Committee’s decision.

During the entire donation process, an Independent Living Donor Advocate will be available to you to ensure your rights as a donor are protected. At the University of Utah Medical Center, the donor advocate is employed specifically to represent and advise the donor; protect and promote the donor’s interests; and ensure that donor’s decision is informed and free from coercion. The Donor Advocate provides counseling and emotional support to donors and families as they proceed through the donation process. The Donor Advocate works closely with the financial counselors to direct donors and families to information and resources that may be helpful related to financial and insurance issues.

Surgery:

If approved the multidisciplinary team will continue to work closely with you to schedule surgery and give you additional information on how your donation process will proceed.

You will be admitted to the hospital the day of your surgery. You will have labs drawn and then proceed to the OR. Once there you will meet with surgical staff that will be there to assist you and answer any remaining questions. At that time they will ask you to sign consent for surgery.

Once you are in the operating room you will be given anesthesia through an IV. After you are fast asleep, a breathing tube will be inserted, a urinary catheter will be placed in your bladder, and the surgery will begin.

A few small incisions will be made in your abdomen to insert laparoscopic instruments. The laparoscope has a small camera that helps guide the surgical team. A 3-4 inch incision is made for the removal of the kidney. The surgical team will use stitches to close the incision.

Follow up:

You will be scheduled to see a surgeon within 2 weeks after discharge. Blood tests will be drawn at 6 months, 1 year, and 2 years following donation. At 1 year, we require all donors to be seen in our post transplant clinic.

The United Network for Organ Sharing (UNOS) regulation requires all transplant programs, including our program, to submit Living Donor Follow-up forms addressing health information for you at 6 months, 1 year, and 2 years post donation. You should expect to be contacted by a member of the transplant team to follow up on specific health information following donation. You should also check your blood pressure regularly.

Your Kidney Donation Team

Transplant Nephrologist

A physician who is an expert in kidney disease, transplantation and donation. Your transplant nephrologist is responsible for determining your medical needs prior to donation, participates in your care during your donation admission, and sees you during clinic appointments following your discharge.

Transplant Surgeon

A surgeon who performs the kidney surgery. Your surgeon is responsible for evaluating your medical condition in preparation for surgery, will discuss the donation with you, will perform the surgery, and will provide post-operative care for a defined period of time following surgery.

Living Donor Transplant Coordinator (Pre-Donation)

A registered nurse who is responsible for managing your case to ensure each detail required for clearance to donate has been reviewed and approved. Transplant coordinators are the primary link between you and your physicians through the process prior to transplant. Close communication with your transplant coordinator is very important.

Living Donor Transplant Coordinator (Post Donation)

A registered nurse (RN) who specializes in kidney donation. The coordinator assists the team in providing post donation care to the patient. The coordinator maintains medical information, monitors labs and medications and works closely with the transplant providers on patient care issues.

Transplant Nurse Practitioner

Nurse Practitioners (NP) are licensed practitioners who work closely with the nephrologists and surgeons to provide medical care to patients before and after donation. They also follow up with patients in post-donor clinic under the supervision of the nephrologists or surgeon.

Transplant Social Worker

A licensed social worker who helps patients and their families understand and cope with a variety of issues related to their donation experience such as emotional, family, and vocational concerns. The transplant social worker is available to help patients at any point in their donation process. Transplant social workers also provide a link to resources in the patient’s local community.

Living Donor Advocate (LDA)

Responsible to meet with the potential donors during the evaluation process to represent, advise and protect the living donor, while promoting the best interests of the living donor. They provide education on organ donation, ensure the patient can make an informed decision, ensure they are free from pressure in making their decision, participate in team discussion about living donors, and are available to donors throughout the donation process and beyond. The LDA has the authority to exclude any living donor if they believe donation is not in the best interest of the potential donor and they do not participate in the care of transplant recipients.

Transplant Dietitian or Registered Dietitian

A registered dietician is available to work with you to determine your current nutritional status and then will provide education regarding nutritional needs, restrictions and supplements that may be necessary to keep you as healthy as possible, before and after the donation.