The Living Donor Journey

Organ donation is an extraordinary act of giving life. While many people receiving life-saving transplants, the number of people who need an organ is greater than the number of organs available for transplant. Just considering living kidney or liver donation may not seem impactful, but it is no small deed to someone who needs and could benefit from this potential donation.

It is important to understand the steps to a living donor transplant, which will ultimately help decide if donating a kidney or liver is an option for you.

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What to Expect

Whether you are hoping to save the life of a loved one or stranger, you can expect to work very closely with a transplant center to evaluate whether you are eligible to donate and to perform the donation surgery.

You can expect to complete an extensive multistep evaluation at the transplant center to make sure you are medically able to donate. As you proceed through the evaluation process, the choice will be yours whether you continue to proceed with the evaluation. The sections below provide additional information to understand the potential risks and the benefits of giving the gift of life as a living donor.

Steps in the Journey

The information about each step in the journey will depend on the organ type. Expand the section for the organ type to see more details about each step.

Considering Donation

You can learn more about your options as a potential living donor, including what choices you have about who you donate to and how organ donation can impact you and the people who are in need of life saving organ transplants.

 

Decide if you would like to donate a kidney to a loved one (directed donation) or someone you don’t know (non-directed donation). For directed donation, discuss your decision with the intended recipient and/or contact their transplant center for information on an evaluation. For non-directed donation, locate and contact transplant centers near you with the SRTR center search page.

Living Donor Evaluation

A potential living donor must complete multiple steps of a thorough medical and psychological evaluation to determine if being a donor is appropriate. Each transplant center has its own evaluation process. Ultimately, an evaluation at a transplant center determines if you are healthy enough to donate.

This may include physical exam, blood compatibility test, psychological assessment, and meeting with an Independent Living Donor Advocate (ILDA). An ILDA ensures that you understand living donor risks and provides the resources you need to decide whether to donate.

Undergoing a psychological evaluation. You may meet with a psychiatrist and/or social worker to review your mental health history and discuss how donating may affect other aspects of your life. Consider joining a support group for living donation, as you will likely need a caregiver for a time after surgery.

Going over financial details. While evaluation and surgery costs are typically paid by the recipient’s insurance, consider if you can afford non-medical expenses like travel, lodging, and time off from work, or whether you would need to seek assistance with the financial burdens of donation.

The evaluation may include discussing whether your decision to donate is entirely your own and not the result of pressure from friends or family.

If the results show you are not compatible with your transplant recipient, you can consider a kidney paired donation exchange program here or here. Kidney paired exchange takes place when two donors are matched with each other’s transplant candidate. This switch allows both to receive a kidney.

After your evaluations, the transplant team will assess your case and determine if you can be a living donor. Depending on the outcome, this may be followed by scheduling your surgery.

You will be scheduled for a living donor kidney transplant surgery. Laparoscopic donor nephrectomy is a common procedure to remove a kidney. This method is less invasive and involves smaller incisions compared to the traditional surgery.

Living Donor Staying Healthy After Donation

After donating, the donor will recover first in the hospital and then at home for a while before returning to normal activities. Recovery time varies for each person. Typically, most people return home after a few days in the hospital. There will be restrictions for a period of time following surgery, such as driving restrictions and limits on the amount of weight you can lift. The donor will be asked by the transplant center to participate in follow-up physical exams for at least two years after donation. The donor will also be encouraged to follow diet and exercise practices to remain healthy.

 

Living Donor Long-term Experiences

While more long-term studies are needed, available research shows that living donors generally are not negatively affected by donation. The majority return to normal activities and do not experience significant differences in their long-term health. The vast majority of living donors have no regrets about donating and would do it again. However, there are some risks to donating. You can learn more about risks in the section below.

Considering Donation

You can learn more about your options as a potential living donor, including what choices you have about who you donate to and how organ donation can impact you and the people who are in need of life saving organ transplants.

 

Decide if you would like to donate a part of your liver to a loved one (directed donation) or someone you don’t know (non-directed donation). For directed donation, discuss your decision with the intended recipient and/or contact their transplant center for information on an evaluation. For non-directed donation, locate and contact transplant centers near you with the SRTR center search page.

Living Donor Evaluation

A potential living donor must complete multiple steps of a thorough medical and psychological evaluation to determine if being a donor is appropriate. Each transplant center has its own evaluation process. Ultimately, an evaluation at a transplant center determines if you are healthy enough to donate.

This may include physical exam, blood compatibility test, psychological assessment, and meeting with an Independent Living Donor Advocate (ILDA). An ILDA ensures that you understand living donor risks and provides the resources you need to decide whether to donate.

Undergoing a psychological evaluation. You may meet with a psychiatrist and/or social worker to review your mental health history and discuss how donating may affect other aspects of your life. Consider joining a support group for living donation, as you will likely need a caregiver for a time after surgery.

Going over financial details. While evaluation and surgery costs are typically paid by the recipient’s insurance, consider if you can afford non-medical expenses like travel, lodging, and time off from work, or whether you would need to seek assistance with the financial burdens of donation.

The evaluation may include discussing whether your decision to donate is entirely your own and not the result of pressure from friends or family.

If the results show you are not compatible with your transplant recipient, you can consider a liver paired donation exchange program. Paired exchange takes place when two donors are matched with each other’s transplant candidate. This switch allows both to receive a liver.

After your evaluations, the transplant team will assess your case and determine if you can be a living donor. Depending on the outcome, this may be followed by scheduling your surgery.

You will be scheduled for a living donor liver transplant surgery. During the procedure, incisions in the abdomen are made and a part of the liver is removed.

Living Donor Staying Healthy After Donation

After donating, the donor will recover first in the hospital and then at home for a while before returning to normal activities. Recovery time varies for each person. Typically, most people return home after 4-7 days in the hospital. There will be restrictions for a period of time following surgery, such as driving restrictions and limits on the amount of weight you can lift. The donor will be asked by the transplant center to participate in follow-up physical exams for at least two years after donation. The donor will also be encouraged to follow diet and exercise practices to remain healthy.

Living Donor Long-term Experiences

While more long-term studies are needed, available research shows that living donors generally are not negatively affected by donation. The majority return to normal activities and do not experience significant differences in their long-term health. The vast majority of living donors have no regrets about donating and would do it again. However, there are some risks to donating. You can learn more about risks in the section below.

Questions to Consider

Patients may not know what information is available to help guide their journey. The questions below are a place to start gathering information using SRTR reports and discussions with your care team.

Living Donor Transplant

For kidney transplant centers, the number of living donor transplants is shown on the center search page.

Living donor transplants usually last longer than deceased donor transplants. From the center search page, separate living and deceased donor outcomes are shown on the center "Full Report". You can compare national and regional outcomes for living and deceased donor transplant on the in an interactive report. Coming soon: watch for a new long-term outcomes calculator.

Some centers participate in programs, such as donor exchanges or chains, that help candidates match with a living donor. SRTR does not have a public list of centers that participate in available programs; however, centers may offer information if you contact them directly.

Considering Donation

If you know who you  intend to donate to, contact that person and his/her doctor to let them know you are interested in being evaluated as a living donor. Also ask for the name of the transplant center where the recipient is listed. You can then find information about that center on the center search page. If you don’t have a recipient already identified, you can contact a transplant center near you to let them know you would like to make a “non-directed” donation. You can find centers here, or you can contact the National Kidney Registry.

Organ donation is major surgery so there are many issues to consider. For example, are you in excellent health? Do you have the financial resources to take time off for testing, surgery, and recovery? Are you donating for the right reasons? Do you have people who can support you while you go through the donation process and recovery? The transplant team can help you address these issues so you make a decision that is right for you.

The medical risks of kidney donation are similar to any major surgery -- infection, surgical complications, even death. Fortunately, these risks are very low. You may also have financial risks such as having to pay for some expenses out of your own pocket or having difficulty getting insurance in the future. You may also experience psychological issues, especially if the donation fails or the recipient dies. Longer-term, there is a slightly higher risk of high blood pressure, protein in urine, and pre-eclampsia in pregnant women. The main benefit of donation is feeling positively about having helped someone. Nearly all donors say they would donate again.

The longest living donor transplants can last several decades. Coming soon: watch for a new long-term outcomes calculator.

Living donor transplants usually last longer than deceased donor transplants. From the center search page, separate living and deceased donor outcomes are shown on the center "Full Report". You can compare national and regional outcomes for living and deceased donor transplant on the in an interactive report. Coming soon: watch for a new long-term outcomes calculator.

You only need one kidney to filter out waste and excess fluid in your body. Most people live a normal life with one kidney. Information about risks is listed in questions below.

Kidney donation is most common. Liver is the other organ that comes from living donors. In donating a liver, only part of the liver is needed since the organ can regrow. While donating a section of the lung, intestine, and pancreas is possible, these are very uncommon. A living person cannot donate a portion of their heart.

Living donors need to be at least 18 years of age. For some centers, the minimum age is 21. Living donation requires a donor to be physically and mentally healthy. Each potential donor is assessed on a case-by-case basis. Even if you think you may not be eligible, if you have an interest in being a living donor, you can contact a transplant center. The transplant center will review your information and will only proceed if your doctors think it is the right decision.

Living Donor Evaluation

Each transplant center has its own approach to evaluating potential living donors but all centers do three things: (1) make sure your blood type matches the recipient, (2) conduct a thorough physical exam to make sure you and the organ you want to donate are in excellent shape, and (3) test that you are psychologically prepared for donation and doing it for the right reasons. Note that you can change your mind about donation at any time during the process.

Centers are looking for potential risks for the long term health of the donor. For some patients, genetic testing may be an option to understand if genetic traits predict future risks. In some cases, the evaluation may show that someone is not an appropriate candidate for organ donation.

The recipient’s medical insurance covers all the medical costs of your donation. However, you may experience lost wages due to time off from work for testing, surgery, and recovery. You may also have to pay for expenses such as travel and lodging. Some organizations have programs to provide financial support, such as the National Living Donor Assistance Center.

Every transplant center is required to have an Independent Donor Advocate (IDA). The IDA acts as your advocate, answers your questions, and promotes your best interests. You can also contact people who have been living donors to ask about their experiences. Social media groups for living donors can be another source of information and support.

The time it takes to evaluate a donor varies widely because each center has a different process, and this information is not reported to SRTR. Therefore, when you meet with the transplant team, ask them to give you a schedule with the steps and timing for their donor evaluation process.

First, find out why the center turned you down. You may have a health issue that was discovered that needs attention. Or there may be an issue like weight that you can address; you can fix the issue and then reapply at that center. Alternatively, you can try to be accepted as a donor at a different transplant center. Each center has its own approach to evaluation so a standard that caused your rejection at one center may be different at another center. Some donor characteristics at different centers, such as age and race, are available on the "Full Report" of each transplant center from the center search page.

Colonoscopy (older than 50)
Gynecologic exam (female)
Antibody screening
Kidney function test
Chest X-ray
Electrocardiogram (EKG)
Urine test
Additional screening based on donor candidates history

Blood type
Weight
Age
Previous Cancer
High blood pressure
Diabetes
HIV+
Substance use
Hepatitis
Heart, liver, or lung disease
Other chronic illnesses or infections
Psychiatric disorders

Yes. Registering to be an organ donor after death is another way to help those on the transplant wait list. Learn more at organdonor.gov. 

Living Donor Staying Healthy After Donation

Most kidney donors are in the hospital one to five days. Only a small percentage (2% or less) need to be readmitted. About 15% of donors have complications, most of which are short-term and minor. Donors are usually able to return to work within six weeks or less (depending on the job). Transplant centers report living donor data up to 2 years after donations; however, current reports list only how many living donors were included in follow-up.

Research studies show serious complications for living donors are rare. Limited data is available for donor outcomes at each center or for regional or national reports rather than outcomes at a center.

Yes, you will have some scars. The amount of scarring may depend on the surgical method used.

Living Donor Long-term Experiences

After you complete your donation, ask the transplant team to give you a personalized plan for maintaining your overall health and the health of your remaining kidney. Participate in follow-up exams with the transplant center six, 12, and 24 months after your donation. Then you should consider continuing with annual physical exams to keep track of your health and your kidney function. Eating properly, exercising, and maintaining an appropriate weight are all important for maintaining long-term kidney health. You will also be asked to avoid medications and supplements that can be harmful to your kidney.

Research studies show serious complications for living donors are rare. However, long-term living donor outcomes are not reported by most centers. A new SRTR Living Donor Collective is engaging with centers to increase long-term follow-up for living donors.

Living Donor Transplant

For liver transplant centers, the number of living donor transplants is shown on the center search page.

Living donor transplants usually last longer than deceased donor transplants. From the center search page, separate living and deceased donor outcomes are shown on the center "Full Report". You can compare national and regional outcomes for living and deceased donor transplant on the in an interactive report. Coming soon: watch for a new long-term outcomes calculator.

Some centers participate in programs, such as donor exchanges or chains, that help candidates match with a living donor. SRTR does not have a public list of centers that participate in available programs; however, centers may offer information if you contact them directly.

Considering Donation

If you know who you  intend to donate to, contact that person and his/her doctor to let them know you are interested in being evaluated as a living donor. Also ask for the name of the transplant center where the recipient is listed. You can then find information about that center on the center search page. If you don’t have a recipient already identified, you can contact a transplant center near you to let them know you would like to make a “non-directed” donation. You can find centers here.

Organ donation is major surgery so there are many issues to consider. For example, are you in excellent health? Do you have the financial resources to take time off for testing, surgery, and recovery? Are you donating for the right reasons? Do you have people who can support you while you go through the donation process and recovery? The transplant team can help you address these issues so you make a decision that is right for you.

The medical risks of liver donation are similar to any major surgery -- infection, surgical complications, even death. Fortunately, these risks are very low. You may also have financial risks such as having to pay for some expenses out of your own pocket or having difficulty getting insurance in the future. You may also experience psychological issues, especially if the donation fails or the recipient dies. Longer-term, some donors report discomfort with the incision and problems with the digestive tract. The main benefit of donation is feeling positively about having helped someone. Nearly all donors say they would donate again.

The longest living donor transplants can last several decades. Coming soon: watch for a new long-term outcomes calculator.

Living donor transplants usually last longer than deceased donor transplants. From the center search page, separate living and deceased donor outcomes are shown on the center "Full Report". You can compare national and regional outcomes for living and deceased donor transplant on the in an interactive report. Coming soon: watch for a new long-term outcomes calculator.

No. Since the liver can regrow on its own, only a portion of the liver is taken from the living donor.

Kidney donation is most common. Liver is the other organ that comes from living donors. In donating a liver, only part of the liver is needed since the organ can regrow. While donating a section of the lung, intestine, and pancreas is possible, these are very uncommon. A living person cannot donate a portion of their heart.

Living donors need to be at least 18 years of age. For some centers, the minimum age is 21. Living donation requires a donor to be physically and mentally healthy. Each potential donor is assessed on a case-by-case basis. Even if you think you may not be eligible, if you have an interest in being a living donor, you can contact a transplant center. The transplant center will review your information and will only proceed if your doctors think it is the right decision.

Living Donor Evaluation

Each transplant center has its own approach to evaluating potential living donors but all centers do three things: (1) make sure your blood type matches the recipient, (2) conduct a thorough physical exam to make sure you and the organ you want to donate are in excellent shape, and (3) test that you are psychologically prepared for donation and doing it for the right reasons. Note that you can change your mind about donation at any time during the process.

Centers are looking for potential risks for the long term health of the donor. For some patients, genetic testing may be an option to understand if genetic traits predict future risks. In some cases, the evaluation may show that someone is not an appropriate candidate for organ donation.

The recipient’s medical insurance covers all the medical costs of your donation. However, you may experience lost wages due to time off from work for testing, surgery, and recovery. You may also have to pay for expenses such as travel and lodging. Some organizations have programs to provide financial support, such as the National Living Donor Assistance Center.

Every transplant center is required to have an Independent Donor Advocate (IDA). The IDA acts as your advocate, answers your questions, and promotes your best interests. You can also contact people who have been living donors to ask about their experiences. Social media groups for living donors can be another source of information and support.

The time it takes to evaluate a donor varies widely because each center has a different process, and this information is not reported to SRTR. Therefore, when you meet with the transplant team, ask them to give you a schedule with the steps and timing for their donor evaluation process.

First, find out why the center turned you down. You may have a health issue that was discovered that needs attention. Or there may be an issue like weight that you can address; you can fix the issue and then reapply at that center. Alternatively, you can try to be accepted as a donor at a different transplant center. Each center has its own approach to evaluation so a standard that caused your rejection at one center may be different at another center. Some donor characteristics at different centers, such as age and race, are available on the "Full Report" of each transplant center from the center search page.

Colonoscopy (older than 50)
Gynecologic exam (female)
Liver biopsy
Liver function test
Chest X-ray
Magnetic resonance imaging (MRI)
Electrocardiogram (EKG)
Computed tomography (CT)

Blood type
Weight
Age
Previous Cancer
High blood pressure
Diabetes
HIV+
Substance use
Hepatitis
Heart, liver, or lung disease
Other chronic illnesses or infections
Psychiatric disorders

Yes. Registering to be an organ donor after death is another way to help those on the transplant wait list. Learn more at organdonor.gov.

Living Donor Staying Healthy After Donation

Most liver donors are in the hospital four to seven days. Only a small percentage (2% or less) need to be readmitted. About 15% have complications, most of which are short-term and minor. Donors are usually able to return to work within 12 weeks or less (depending on the job). Transplant centers report living donor data up to 2 years after donations; however, current reports list only how many living donors were included in follow-up.

Research studies show serious complications for living donors are rare. Limited data is available for donor outcomes at each center or for regional or national reports rather than outcomes at a center.

Yes, you will have some scars. The amount of scarring may depend on the surgical method used.

Living Donor Long-term Experiences

After you complete your donation, ask the transplant team to give you a personalized plan for maintaining your overall health and the health of the remaining portion of your liver. Participate in follow-up exams with the transplant center six, 12, and 24 months after your donation. Then you should consider continuing with annual physical exams to keep track of your health and your liver function. Eating properly, exercising, and maintaining an appropriate weight are all important for maintaining long-term liver health. You will also be asked to avoid medications and supplements harmful to your liver.

Research studies show serious complications for living donors are rare. However, long-term living donor outcomes are not reported by most centers. A new SRTR Living Donor Collective is engaging with centers to increase long-term follow-up for living donors.

Donating Life: Outcomes & Opportunities
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Donating Life: Outcomes & Opportunities

The increased need for organ transplants has sparked encouragement of the general public to consider living donation. However, data on the long-term effects of living donation remains limited. These unknowns are obstacles for both transplant professionals and potential donors, who either struggle to meet transplant needs or to make an informed decision on donating.

Keep Exploring

See more about who plays a part in the journey and follow each step in the transplant system using the Interactive System Map.

Keep Exploring

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