OSF Saint Francis Medical Center

Peoria, Illinois

Living Donation

About Organ Donation

You can make a difference by donating a kidney to someone facing kidney failure. Since 1985, our transplant program has been utilizing living donations to provide the gift of life through living donor kidney transplantation.

This has allowed hundreds of people to live longer, healthier lives, free from the challenging routine of dialysis. Donating a kidney not only helps the person who receives the kidney but also shortens the deceased donor wait list, helping another person get a deceased donor kidney sooner.

The best option for a patient waiting for a kidney transplant is to receive one from a living donor, but the number of people waiting far exceeds the number of donors. At any given time, over 100,000 patients in the United States are awaiting a kidney transplant according to the United Network for Organ Sharing —many people whose lives can be changed by a living donor.

Education is the most important component in the decision to become a living donor. If you are considering becoming a living donor, please complete the Become a Living Donor Form , or you can speak with a transplant donor coordinator at (309) 624-5433.

Who can be a living donor?

The decision to become a living donor is a voluntary one, freely given without pressure or financial compensation from the intended recipient. The donor may change his or her mind at any time during the process. The donor’s decision and reasons are kept confidential. All results of the medical evaluation of the donor will be held confidential according to HIPAA guidelines.

 A living donor is often a close family member, such as a parent, child, brother or sister. A donor can also be a more distant family member, spouse, friend, co-worker or church member. Altruistic or non-directed donors—those who donate anonymously and do not know their recipients—are also becoming more common.

To qualify as a living donor, a person must be physically fit, in good health and free from high blood pressure, diabetes, obesity, and kidney disease. Individuals considered for living donation are usually between 18 and 65 years of age. Gender and race are not factors in determining a successful match.

Additionally, the prospective donor and recipient must have a compatible blood type (see blood type compatibility chart) and cross-match. It is important to know that even if a donor’s blood type is not compatible with the recipient’s blood type, there is still the option to be an indirect donor for your recipient through our paired kidney exchange program.

Donor Blood Type Recipient Blood Type
Blood Type Compatibility Chart
                        A                        A and AB     
                        B                        B and AB
                        AB                             AB
                        O                        A, B, AB and O

Note: The Rh factor (positive or negative) with the blood type does not have to match for donation.

What to Expect

The evaluation tests will be done in stages. Once the potential donor passes one stage, they will move on to the next stage of the evaluation process.

First, the potential living donor must call the transplant office at (309) 655-4101 or (800) 635-1440 and speak to a transplant team member. The team member will take some basic information and pass the referral on to a pre-transplant coordinator. The transplant coordinator will discuss donation, answer your questions and send an information packet out to you.

After you have reviewed the information, please complete the enclosed donor questionnaire and detailed health history and return it to the transplant office in the provided envelope. The questionnaire and any available medical records will be reviewed with the physicians and health care team for an evaluation process plan.

Your recipient must be approved for transplant by the transplant team prior to further testing. There may be several potential donor offers to for one recipient, but only one donor will be evaluated at a time.

The testing you can expect during your evaluation process includes:

  • Blood work will be drawn to confirm your blood type and basic screening labs to check your kidney function, screen for diabetes, and check your urine for abnormalities.
  • 24-hour urine collection to evaluate the function of your kidneys.
  • HLA Tissue Typing: this blood test checks the tissue match between the donor and the recipient. Your cells have six human leukocyte antigens (HLA): three from each parent. This is why family members are most likely to have matching antigens. A complete HLA match is not required as long as the blood type matches and other tests are negative.
  • Cross-match: this test involves a mixing of the donor and recipient blood sample to see if there is a reaction which would cause a potential rejection of the transplanted kidney. If no reaction occurs, the result is called a negative cross-match and the transplant operation can proceed. If reaction does occur, the result is called a positive cross-match, meaning that the risk of rejection of the kidney is too high. In this case, the donor and recipient may decide to explore the option of the paired kidney exchange program or another donor may step forward and start the evaluation process.
  • Chest X-ray and EKG to evaluate your heart and lungs.
  • Blood tests to screen for possible transmissible diseases: these tests may determine if the donor has had or been exposed to HIV/AIDS, hepatitis, or other diseases. Some positive test results may need to be reported to local, state, or federal health authorities for public health reasons.
  • CT angiogram of kidneys (an x-ray test to evaluate the anatomy of the kidneys and blood vessels).
  • Cancer screening testing as age and risk appropriate may include a colonoscopy, mammogram, Pap smear, prostate exam, and skin cancer screening.
  • Any additional testing as needed

Your donor evaluation will also include being seen by the transplant health care team which includes a surgeon and a nephrologist, transplant coordinator, social worker, financial coordinator, dietician, pharmacist and independent living donor advocate. The decision about whether to accept the donor is made by the transplant center health care team.

Independent Living Donor Advocate

Federal regulations require transplant programs to appoint an independent donor advocate to ensure safe evaluation and care of living donors. An independent living donor advocate’s role in counseling potential living donors includes but is not limited to:

  • Identifying potential emotional risks to the donor.
  • Determining whether the donor is capable of making the decision to donate and cope with the stress of a major surgery.
  • Exploring rationale for donation to be sure the donor is free of pressure or guilt.
  • Discussing how donation might impact the donor’s job or family relations.
  • Reviewing the nature of the relationship between donor and recipient.
  • Determining the support systems that are in place for recovery.
  • Ensuring the donor understands risks of complications, recovery phase, and financial aspects of donation and commitment to postoperative follow-up care.
  • Reinforcing that the transplant center will not discuss the donor evaluation with the recipient.

Donor Financial Information

The medical expenses for the testing required for the donor evaluation and surgery are covered by the recipient’s medical insurance. However, it’s important to remember that travel, lodging, and time off work are not covered by insurance. Some donors may qualify for assistance with travel and lodging through the National Living Donor Assistance Center. You should talk about this program and any financial concerns with the transplant financial worker or social worker.

About the Surgery

The surgeon will determine which surgical approach is best based on the donor’s anatomy and the CT testing results. Most living kidney donation surgery is performed via a minimally invasive laparoscopic donor nephrectomy, a procedure that greatly improves the surgical experience for the donor. Only two to three one-inch incisions are made in the abdomen and a three-inch incision near the belly button. The surgeon then uses thin tools and a digital camera to remove the kidney through the larger incision. The kidney then will be taken to an adjacent operating room where it will be implanted into the recipient.

In some cases it may be necessary to use a smaller open donor nephrectomy because of a patient’s anatomy. In this approach, a four- to five-inch incision is done on the right or left side to remove the kidney.

Both surgeries are performed under general anesthesia in a safe environment of the operating room suites. Surgery times may vary but are generally completed in two to three hours. After surgery, the donor will stay in the post-anesthesia recovery area until they are awake and stable enough to go to the urology unit of the hospital. Donors will be given pain medication through an intravenous line to keep your pain under control. On the urology unit, the team who provides your care has been specially trained in the management of transplant donors and recipients.

Minimally invasive surgery speeds recovery for kidney donors. Our goal is to help you get back to your job and the rest of your life as fast as possible. Although many laparoscopic procedures take about the same amount of time in surgery as an open-incision surgery, the recovery time is reduced because you do not have to recuperate from a large incision.

Other benefits of minimally invasive surgeries include less scarring, reduced blood loss and shorter hospital stay. Hospital recovery is usually only two to three days, and most donors are able to return to work within four to six weeks after the surgery.

Risks

The overall risks for a living kidney donor are considered to be low and about the same as the general population who have not donated a kidney. Living donation does not change life expectancy for the donor, who can continue to lead a normal life after recovery from the surgery. Studies have shown that one kidney is enough to remove wastes and excess fluid from the blood to keep the body healthy.

People with one kidney may be at a greater risk of high blood pressure or reduced kidney function. After donation, it is vital that the donor’s health is monitored regularly. The transplant center is required to report information about the donor’s health to the United Network for Organ Sharing at 6 months, 12 months, and 24 months post donation. You will be required to commit to follow-up care with either the transplant center nephrologist or your primary physician.

In the unlikely event that a living donor ever needs a kidney later in life, they are given higher priority on the deceased donor list based on the current allocation system.

It is important to realize that although living donor kidney transplants are highly successful, problems may occur. Sometimes, the kidney is rejected or the original disease that caused kidney failure may return and cause the transplanted kidney to fail.

The transplant surgeon and nephrologist will discuss risks in further detail with your evaluation appointment.

Benefits of Living Donation

Transplants performed from living donors may have several advantages compared to transplants performed from deceased donors:

  • Some living donor transplants are done between family members who are genetically similar. A better genetic match may lessen the risk of rejection.
  • Preservation time and transportation are not factors. Donor and recipient operating rooms are adjacent to each other, and the living donor kidney can be transplanted and functioning within a short time. Some deceased donor kidneys do not function immediately. As a result, the patient may require dialysis for a short period of time until the kidney starts to function.
  • Potential donors can be tested ahead of time to find the donor who is most compatible with the recipient. The transplant can take place at a time convenient for both the donor and recipient.
  • Receiving a kidney from a living donor keeps recipients from long waiting time for a deceased donor kidney.
  • Living donor kidneys tend to last significantly longer than deceased donor kidneys.

Paired Kidney Exchange Program

The goal of a paired kidney exchange is to make optimal use of willing live donors. Paired kidney exchanges help get potential recipients off the transplant waiting list and back to leading productive lives more quickly.

In a paired kidney exchange, two kidney recipients swap willing donors. While medically suitable to donate, each donor may have an incompatible blood type or incompatible antigens with his or her intended recipient. By agreeing to exchange recipients—giving the kidney to an unknown, but compatible individual—the donors can provide two patients with healthy kidneys where previously no transplant would have been possible.

Our transplant program participates in the following paired exchange programs: the UNOS Kidney Paired Donation program, the National Kidney Registry program, and the Alliance for Paired Donation program. Participating in paired exchange programs increases the opportunity to find compatible matches for our patients.

Click here to see the impact of paired kidney donation in action.

Compatibility Chart