In the U.S., about 109,000 people are waiting for an organ transplant. In 2019, there were almost 40,000 transplant surgeries performed—about 108 each day—but there are still 17 people on average who die everyday while waiting for a transplant, according to the U.S. Government Information on Organ Donation and Transplantation.
One important step that everyone can take is to become an organ donor by making sure your driver's license, legal will, or other legal documents indicate your desire to do so. While organ donation is important, it only accounts for a fraction of the organs needed by patients around the country. The vast majority of people on the transplant waiting list are in need of a kidney, and for these patients there might be another option: living organ donation.
What is living organ donation?
"Living organ donation is the process of donating either a portion of an organ or the entire organ while you are still alive," explains Shalei Valentine, BSN, who is the Living Donor Transplant Coordinator at University of Utah Health. Most healthy people have organs they don't exactly need—such as two kidneys, when one kidney can meet your needs—and can safely donate one of them to someone in need. In some situations you can also donate a portion of an existing organ that will regenerate (grow back) after it is removed.
A living donor could donate:
- One kidney
- One lung
- Portion of liver
- Portion of pancreas
- Portion of intestine
Criteria for living organ donors
To be a living organ donor, you first need to be interested in donating—it's a significant decision and not one that should be taken lightly. You also must meet specific health criteria. Donors get an extensive physical health workup to make sure that a living organ donation will not jeopardize their health once the donated organ is removed. That includes:
- A full workup by a physician, surgeon, nurses, dietitian and social worker
- Blood tests
- Urine tests
- Imaging tests, including chest x-ray, electrocardiogram (EKG), and CT scan to examine organs and the blood vessels around them to make sure they are healthy
In addition to physical health, doctors and program coordinators also want to make sure you are mentally and emotionally ready for the process. It's a voluntary procedure—it is not necessary to preserve the donor's life—but it still comes with the same risks as any surgery. For those reasons, living donors also must undergo a psychosocial evaluation from a social worker.
Understanding the process
For most living organ donors, the process from start to finish can take about eight to twelve weeks. While some donors might be able to complete the evaluation quicker, the process can be frustrating for someone with a loved one waiting for a life-saving transplant. The most important thing to understand is that the living donor transplant team will never rush a donation just because someone needs it.
After passing all the physical and mental health criteria and the committee approves your living organ donation, you will undergo surgery to have a kidney or a portion of your liver removed. This procedure does come with the same risks as any surgery, including the potential for complications. Your doctor will discuss all the risks with you prior to the procedure, and at any point before you go in for surgery you can change your mind.
Who can and cannot donate living organs
Once someone gets through all the tests and examinations, it's up to a committee to decide if a living organ donation is the right decision. One single person cannot approve or deny a living organ donation, which helps avoid any bias or unnecessary risk. The team that approves a living organ donor is also completely separate from the organ donation recipient's care team, so a donor will not feel pressured or be asked to take on more risk than is necessary.
It can be a difficult balancing act, says Valentine, because many family members are willing to put their own lives at risk to save a loved one. As medical professionals, the obligation of the care team at University of Utah Health from the Hippocratic Oath is to do no harm, so they must weigh any risks to the donor separate from the needs of the potential recipient
With advancements in immunosuppression medications, many people who were previously not an identical twin or a perfect genetic match can now become living donors. You will need to have a compatible blood type, and during your physical workup the doctors will determine whether you meet other matching criteria, such as tissue typing for matching antigens. The better your match, the less likely the recipient will reject the organ.
Since not everyone is a good match with a family member, loved one, or friend who needs a living organ donation, there are also paired exchanges. These programs take people willing to be organ donors and match them with someone who is in need (who they do not know or are not related to), ensuring the best possible match for everyone.
There are also many people who would like to donate but are unable to do so because they do not pass the screening process due to:
- Diseases that affect their health as the donor
- Diseases that impact kidney function, such as uncontrolled high blood pressure or diabetes
- Active cancer
- Being younger than 18 years old
If you are unable to donate, you can still support living organ donation by:
- Raising awareness about the need for living donors
- Donating or raising money for organizations that support living organ donation, education, and research
- Giving your time and energy to causes that support living organ donation
Learn more about living organ donation
The most common situation for someone to become a living organ donor is when you have a family member or loved one who needs a kidney, but you can also choose to become an 'altruistic donor' and simply give your kidney or a portion of your liver to someone who needs it.
"Utah has one of the highest rates of altruistic living donors who are willing to donate to anyone in need," Valentine says. "We are so grateful for all of our donors, and it really speaks to a our culture of giving and people wanting to help others in any way they can."