FAQ
Who is eligible to donate a kidney? Do I need to be related to the recipient to donate?
According to Canadian Blood Services, any healthy adult can be considered for living kidney donation. A potential donor could be a family member, friend, neighbour, or acquaintance of the transplant candidate who is freely willing to donate. The potential donor does not have to be the same age, sex or ethnicity as Darin, our intended kidney recipient. In fact, it can be anyone who is willing to donate.
Both the potential donor and Darin must complete medical tests and evaluations before they can go ahead with donation and transplantation. For example, the potential donor must be healthy enough to have surgery and to remain healthy with only one kidney. Likewise, even though Darin has end-stage kidney disease and needs a new kidney, he must be healthy enough to have the surgery and be able to handle the anti rejection treatment afterwards. Special blood tests are done to see if the donor’s blood and tissue type match that of Darin. If these factors match, the potential donor and Darin are called a “compatible pair” and the candidate can receive a kidney from that donor. The medical tests and evaluations will require daytime medical appointments.
After the donation, it is expected that the donor will remain in good health. Staying healthy includes getting regular checkups and health care from their family doctor.
Source: https://www.blood.ca/en/organs-tissues/living-organ-donation/am-i-eligible-be-living-kidney-donor
What is a direct vs non-directed kidney donation? What is the Kidney Paired Donation (KPD) program? How does kidney paired donation work?
A direct kidney donation occurs when special blood tests are done to see if the donor’s blood and tissue type match that of Darin. If these factors match, the potential donor and Darin are called a “compatible pair” and Darin can receive a kidney from that donor.
When this is not the case, the potential donor can still ensure that Darin receives a kidney donation through non-directed means. One such way is through the Kidney Paired Donation program, this is a Canada-wide program run by the Canadian Blood Services in partnership with all living kidney donation and kidney transplant programs in the country. The KPD program matches incompatible living kidney donor and recipient pairs to other incompatible pairs. A living kidney donor of an incompatible pair can donate to another recipient in Canada with whom they are compatible, while their original recipient receives a kidney from a different living kidney donor in the program that is compatible with them. According to the UHN Kidney Donation education manual, the recipient surgeries typically do not take place on the same day, but usually within the same week.
According to Canadian Blood Services, to enroll in the Kidney Paired Donation program, each donor and candidate must sign a consent form giving permission for their medical information to be entered in the Canadian Transplant Registry. This registry is a secure computer database for the Kidney Paired Donation program. Canadian Blood Services manages the Registry and the computerized matching process.
Specific personal and medical information for all enrolled donors and transplant candidates is entered into the Registry to allow matching. The Registry tries to find potential donors who can be matched to transplant candidates anywhere in the country. Once matched, a donor may need to repeat some medical tests or have other tests done to make sure their kidney is suitable for the matched transplant candidate. Once all matches in the chain have been approved, donors from incompatible pairs are swapped to create compatible pairs. The transplant teams across the country work together to arrange the donation and transplant surgeries.
Source: https://www.blood.ca/en/organs-tissues/living-organ-donation/kidney-paired-donation
https://www.uhn.ca/Transplant/Living_Donor_Program/Documents/Living_Kidney_Donor_Manual.pdf
Who cannot be a kidney donor?
According to the UHN Living Kidney Donation Program, here are the criteria for those who can not be a kidney donor:
- Person younger than 18 years of age
- Confirmed diagnosis of Type 1 or Type 2 diabetes
- History of Melanoma (a type of skin cancer). Donor candidates with a history of squamous cell and basal cell carcinoma can proceed with the evaluation.
- Body Mass Index (BMI) greater than 35 kg/m2. Calculate your BMI.
- History of heart bypass surgery, heart attack, cardiac stents or a stroke
What are the steps in the donor evaluation process?
Screening: Submit a Donor Health History Form, along with documentation of your blood type if available, to the Living Kidney Donor program. If you are suitable to begin the evaluation process, the living kidney donor program will discuss the next steps with you to begin your evaluation.
Assessment: You will need to come to Toronto General Hospital at least 3 times to complete your evaluation. Based on your age and your medical history, you may have all or some of these tests:
- Blood tests, screening for diabetes and virus testing
- Heart tests such as an electrocardiogram (ECG) or a treadmill stress test
- Chest x-rays, CT scans of the abdomen and a renal scan
- Age appropriate screening for cancer
- TB skin test
You will also meet with living kidney donor coordinator, social worker, donor nephrologist, nurse practitioner, donor surgeon and anesthetist. You may also need to be seen by a psychiatrist. Depending on your results, you may have to meet other healthcare professionals and go through other tests.
Approval: After your evaluation is complete, your donor team will review all your test results and will talk to you about whether donating a kidney donation is right for you.
You may be approved to become a kidney donor if:
- All required tests and consultations have been done.
- You have met and talked with all members of the donor team who are involved in your evaluation.
This process is only applicable to those living within Ontario, Canada. If you would like to donate and are living nationally or internationally, please contact Samantha (647-226-9834) for more information about this process.
Source: https://www.uhn.ca/Transplant/Living_Donor_Program/Pages/kidney_donor_evaluation.aspx#step3
What is the Program for Reimbursing Living Organ Donors (PRELOD) and what reimbursements are included?
PRELOD provides reimbursement to living organ donors and potential living organ donors for eligible out-of-pocket expenses and lost income during the assessment and surgery periods of the organ donation process. PRELOD is a program which aims to reduce the financial burden associated with the living kidney donation process.
With PRELOD, living kidney donors can receive reimbursement for the following items:
- Travel expenses incurred
- Parking/Transit
- Accommodation
- Meals
- Loss of Income Subsidy After Surgery
Of note, claims made for follow-up assessments after surgery are eligible for reimbursement for one year after surgery. Reimbursement for companion expenses (travel, accommodation, meals) is also available during the surgery and recovery period.
Source: https://www.uhn.ca/Transplant/Living_Donor_Program/Documents/Living_Kidney_Donor_Manual.pdf
https://kidney.ca/Support/Programs-Services/living-organ-donor-reimbursement-program
Is the donor’s medical information confidential?
As a potential living kidney donor, your care team will be separate from the care team of Darin. Your health information will be kept confidential and will not be shared with Darin.
If you know Darin or Samantha, we encourage you to talk to them about your status. If you wish to remain anonymous, please indicate this to your living kidney donor coordinator at the beginning of your assessment.
Source: https://www.uhn.ca/Transplant/Living_Donor_Program/Pages/kidney_donor_evaluation.aspx#step3
Once my donor eligibility is confirmed, how soon will the transplant procedure occur?
According to the UHN Living Kidney Donation Program, once your kidney donor evaluation is complete and the donor team clears you to donate, the operations for you and the recipient will be scheduled. You will have an appointment with the surgeon usually one week before your operation. During this appointment, you and the surgeon will talk about the type of kidney operation you will have.
What preparations are required for the transplant surgery?
DO:
- Keep a healthy diet.
- Exercise regularly.
- Practice safe sex.
- Avoid contact with sick people.
DON’T:
- Take part in high-risk activities that may give you infections. This includes unprotected sex, drug use, tattoos and piercings.
- Do not smoke. It is strongly recommended for you to quit smoking permanently if you wish to be a living kidney donor.
- Do not drink alcohol excessively. We recommend following the general guidelines for alcohol consumption.
- Use any drugs without your doctor’s approval. You do not use any non-prescription medication unless you have checked with the donor team.
- Do not book any travel without checking with your living kidney donor coordinator. Travel to certain destinations may affect your timeframe for kidney donation.
- For women only: Stop taking birth control pills or any kind of hormone treatment. Do this at least 4 weeks before surgery.
Source: https://www.uhn.ca/Transplant/Living_Donor_Program/Pages/kidney_donor_evaluation.aspx
What does the transplant procedure entail?
According to the Living Kidney Surgery Guide, there are two types of procedures:
- Modified Traditional Mini-Incision
A 4-inch incision (cut) is made on your side, about 2 inches back from the tip of the 11th rib and extending 2 inches forward, toward the front of the abdomen.
Depending on the blood supply of your kidneys, either the right or left kidney is removed along with all its blood vessels and its ureter (the tube that carries urine from the kidney to the bladder).
Your remaining kidney will then begin to take on some of the work that was previously performed by both kidneys.
Staples are used to close the incision; they will be removed 7 to 10 days after the surgery and we suggest that your family doctor removes these staples.
This operation lasts about 1 1/2 hours and the hospital stay is usually 3 to 5 days.
- Laparoscopic Nephrectomy
Three or four small, 1/2 inch incisions are made in the upper left part of the abdomen, to allow access for a small camera and operating instruments.
An incision about 4 inches in length is made in the lower abdomen, and the kidney is carefully removed. A television screen is used to monitor the surgery.
Sutures are used to close the incisions and the skin is closed with Steri-Strips. This operation takes about 3 1/2 hours to complete and the hospital stay is usually 3 – 5 days.
What is recovery like for kidney donors? Will I have a normal life after surgery?
People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney.
Physical exercise is healthy and good for kidney donor. However, it’s important for someone with only one kidney to be careful and protect it from injury. Some doctors think it is best to avoid contact sports like football, boxing, hockey, soccer, martial arts, or wrestling. Wearing protective gear such as padded vests under clothing can help protect the kidney from injury during sports. This can help lessen the risk, but it won’t take away the risk. Donors are encouraged to speak to their healthcare provider if they want to join in contact sports.
Donors are encouraged to have good long-term medical follow-up with their primary care doctors. A urine test, a blood pressure check and a blood test for kidney function should be done every year.
Living donation does not change life expectancy, and does not appear to increase the risk of kidney failure. In general, most people with a single normal kidney have few or no problems; however, potential donors are advised to speak to their transplant team about the risks involved in donation. Some studies report that living donors may have a greater chance of developing high blood pressure. It is recommended that potential donors consult with their doctor about the risks of living donation.
Source: https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation
Is the surgery dangerous for the donor?
As a potential living kidney donor, you should know that living kidney donation comes with some risks which your doctor will discuss with you before the surgery. Living kidney donation is a major surgery and even though living kidney donors are generally in good health, there are always certain risks associated with surgery. Rarely, after surgery, living kidney donors may experience the following:
- Bleeding during surgery which may require a blood transfusion. This is rare, and less than 1 person out of 500 people will require a blood transfusion.
- Development of a blood clot which may cause leg swelling or difficulty
- breathing. This is also rare, occurring in less than 1% of donors. All living kidney donors are given a small dose of heparin (a blood thinner
- medication) during their hospital stay to decrease the risk of blood clots.
- An infection such as a lung infection, skin infection or bladder
- infection. Less than 4% of living kidney donors will experience an infection, which is typically treated with antibiotics for approximately 1 week. These are usually given in tablet form by mouth. A single dose of antibiotic is given in the operating room just before surgery to decrease the risk of infections.
- A temporary collapse of the lung, which could interfere with breathing. Should this occur, the lung can be re-expanded again. This is rare and less than 1 percent of living kidney donors experience this complication.
- An allergic reaction to anaesthesia or a complication associated with
- any anesthesia and major surgery, such as stroke, heart attack, or death, although this is extremely rare (1 person out of 10,000).
What are the long-term risks of donation?
Kidney donors will also have a scar from the donor operation- the size and location of the scar will depend on the type of operation you have. Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction. These risks seem to be rare, but there are currently no national statistics on the frequency of these problems. In addition, people with one kidney may be at a greater risk of:
- high blood pressure
- Proteinuria
- Reduced kidney function
Before determining whether a potential donor is eligible to proceed with the transplant evaluation and in turn, the transplant itself, the transplant team does a careful job in ensuring the health of the donor is not compromised and all health risks are minimized. Potential donors are encouraged to speak to their transplant team about any risks that might be worrisome to their overall health.
Source: https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation
Why is receiving a kidney from a living donor preferred to a deceased donor?
- The waiting time for a kidney transplant is much shorter. This may decrease the time that a person with kidney failure must spend on dialysis, or dialysis can even be avoided altogether.
- The transplant date can be planned ahead of time, thereby allowing time for both the living kidney donor and recipient to plan and prepare for surgery.
- A kidney from a living kidney donor generally lasts longer than a kidney from a deceased donor and usually works well right after the surgery.
Source: https://www.uhn.ca/Transplant/Living_Donor_Program/Pages/kidney_donor_evaluation.aspx