first do no harm
The concerns of most potential living donors revolve around the risks of surgery and the consequences of living long term with only one kidney. Livers regenerate a new lobe. Lungs do not regenerate.
living kidney donors
Nephrectomy, the removal of a kidney, is considered a major surgical procedure and has the usual risks associated with any surgery. For healthy individuals, these risks are small. All donors must undergo an extensive medical and psychological evaluation to assure their suitability for donation and surgery. The transplant will only be scheduled if the transplant team feels confident that the potential donor will not be jeopardized in any way.
Some conditions such as smoking and severe obesity add significant risk to the donor’s surgery. It is expected that donors stop smoking at least 3 months prior to surgery. Some donors may be asked to participate in a weight loss program. In addition, donors are screened carefully to determine any increased risk of developing hypertension, diabetes or kidney failure in the future.
Only one kidney is necessary to provide good health and a normal life. The living kidney donor can expect to live a normal life span and enjoy an excellent quality of life.
Kidney donation does not affect a woman’s ability to have a normal pregnancy and childbirth.
After recovery from surgery, you can work, drive, exercise, and participate in sports as usual. It is important, however, for the donor to avoid accidents that may damage the remaining kidney. Such accidents are usually the result of major trauma or severe sports injuries. For that reason, donors are advised to avoid extreme contact sports and risky activities such as boxing or tackle football. You can continue in all types of occupations, including military duty.
psychological and emotional considerations
Donation must be a totally voluntary act, free of any monetary or other material coercion. The transplant team will have extensive discussions with the potential donor about his or her motivations and expectations. In particular, the donor must remember that success of the transplanted organ is not guaranteed, and there may be some feelings of regret or responsibility if things do not turn out as well as anticipated.
Most living donors believe that the emotional advantages of donating a kidney outweigh the disadvantages. Studies have shown that after the transplant, many donors experience an improved self-image and report a closer relationship with their organ’s recipient. Many living donors also feel that donating an organ while alive is more rewarding than the possibility of potential cadaveric donation of their organs.
In order to ensure that donor costs are appropriately covered by the recipient’s insurance, it is first necessary that the potential recipient be approved as a transplant candidate before proceeding with any assessment or evaluation of the donor. The recipient’s insurance will be asked to pay for the donor’s pre-transplant work-up, surgery, hospitalization and any complications directly related to organ donation. Usually these costs are covered expenses by the recipient’s insurance. If the recipient’s private insurance will not cover your costs and if the recipient is eligible for Medicare’s End Stage Renal Disease (ESRD) program, the medical bills will be covered by Medicare.
The living donor does not pay for his or her medical expenses. However, the financial impact of wages lost during the post-operative recovery period when he or she may be unable to work, as well as possible costs for travel, lodging, and childcare should be considered. An insurance plan occasionally will allocate funds for the donor’s lodging and travel expenses, but none give compensation for lost wages.
A social worker will discuss financial issues with the donor during the pre-donor evaluation. Although he or she can assist in finding resources to pay for some of the uncovered non-medical expenses, donating a living kidney may not be financially feasible for everyone. The transplant team prefers honesty in this area and respects the needs for those who must decline to donate for financial or other reasons.