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Understanding Living Kidney Donation

Understanding Living Kidney Donation

1. Who Can Be A Living Kidney Donor?

Most people in good health can be considered for testing to see if they’d qualify to become a living kidney donor. The qualification process typically begins with a telephone screening that determines if a thorough evaluation should follow. The evaluation typically includes several interviews, exams, scans and lab tests. The transplant center requires these tests to ensure the person who wishes to donate is healthy enough to do so.

2. What’s the Surgery Like? What Are the Risks?

The Surgery:

The surgery is performed with small incision, which is known as laparoscopic surgery. In kidney donation (also known as a nephrectomy), the procedure typically involves four 1-inch slits in the area of the stomach and bladder.  There is also one four-inch incision made around the navel. This incision is a bit larger, so the kidney can be removed from this area. 

Risks:

The surgical process for removing a kidney from a healthy individual has become a fairly standard procedure. Nonetheless, the procedure still carries the same level of risk as any other major surgery. The most common risks associated with kidney donation (also known as a nephrectomy) can include blood clotting, infection and a reaction to the anesthesia. The risk of death from donating a kidney is less than one percent, or 0.0003 % (which is about 3 in every 10,000 surgeries).

Hospital Stay:

Hospital recovery for donating a kidney usually involves 1-3 overnight stays. Hospital discharge is determined by the donor’s health and their ability to get out of bed and walk on their own.   

Discomfort:

Because the kidney donor will feel pain after surgery, pain medications will be provided to help patient comfort. It is not uncommon for some patients to experience constipation from pain medication. Because of this, laxatives may be provided. 

Work & Activities:

Most living kidney donors can resume their regular activities within 3 weeks after donation, providing they are less strenuous activities. Depending on the type of work the kidney donor performs and the level of difficulty, kidney donors can often go back to work within 3-5 weeks.  If the donor’s job is a desk job, they can often get back to work even sooner. Those engaged in more strenuous activities are advised to refrain from difficult physical tasks until they are completely recovered.

3. Who Pays For The Kidney Donor’s Tests, Surgery and Hospital Stay?

The medical insurance covering the individual who receives the donor’s kidney will cover the donor’s medical costs. Things that are not covered or paid for (by the transplant patient’s insurance company) can include the donor’s time off from work, recovery care and travel costs. There are a few states that now require employers to cover living kidney donor’s time off work for a set period of time. *It is wise to check with employer policies, state laws and federal updates.

4. Can A Living Kidney Donor Live A Normal Life After Donating?

There are many studies showing living kidney donors doing quite well after they donate a kidney. For the most part, their health and quality of life remains unchanged. The most notable change expressed by most living kidney donors comes in the form of the perpetual joy they feel for their extraordinary act of human kindness. 

Living kidney donors aren’t typically required to take new medications following the surgery, other than a pain medication or a stool softener for a short period of time. Likewise, kidney donors do not need to follow a special diet after they are discharged from the hospital. They are, however, asked to avoid alcohol while taking pain medication. The guideline for alcohol consumption after kidney donation is fairly standard. Living kidney donors should be responsible and consume alcohol in moderation.

5. What Emotions Might The Kidney Donor Feel After Donation?

Like any new experience, donors can often feel both excitement and anxiety from time to time. Typically, the more the donor understands going into the process, the less anxiety they’ll experience. Post-surgery, donors often report a feeling of honor and joy. As a result, their uplifting attitudes have been found to reduce post-surgical pain, while also boosting perceptions of recovery inconveniences. 

6. How Successful Are Living Kidney Donor Transplants?

Hospitals with established transplant programs show very good transplant success rates. Most transplant centers* exceed a 95% success rate one year after transplantation.

The best success rates are seen in transplants from living kidney donors. (*Transplant programs are required to keep track of their success rates. Be sure to ask the center to share their success rates).

7. Is There An Age Requirement (or Cut-Off ) to Donate a Kidney?

Generally, the ideal age range to donate a kidney is 18-65 years old. Of course, the kidney donor will need to be healthy enough to donate a kidney safely. While there have been donors who have donated a kidney after the age of 65; younger donors are preferred. Family members are also preferred, as they offer a better match.

8. What If I’m Not A Compatible Blood-Type Match?

Often times, potential donors can be incompatible in blood type or have antibodies that would fight against their intended recipient. When the living kidney donor is not an ideal match for their intended recipient they can still donate—just not directly. This is accomplished through a Paired Exchange Program.

In Paired Exchange, a computer algorithm is used to find a better match for incompatible groupings. In this model, the living kidney donor’s kidney is swapped with another person’s incompatible living kidney donor.

There is also something known as Compatible Pairs, where  a donor and patient that are biologically compatible (but want to find a better match through a paired exchange swap) agree to be matched with more suitable donors to increase the chance that the transplanted kidney will function better and last longer. 

What About Advanced Donation (ADP)?

Advanced Donation, also known as ADP, offers a unique kidney paired exchange opportunity, separated in time.

There are four types of ADP cases. 1) Short term cases, where the intended recipient is on dialysis or is in imminent need of a kidney transplant. 2) Short Term Swap Saver, where the paired donor proceeds with donation to keep the rest of a swap on schedule, but the recipient remains in imminent need of a kidney transplant. 3) Voucher cases, where the intended recipient is currently not in need of a kidney transplant, yet they may need a transplant in the future; and the 4) Voucher Swap Saver, where the donor proceeds with donation to keep the rest of a swap on schedule. This occurs after their intended recipient is transplanted by kidney from another living donor or a deceased donor. 

9. Am I Able to Change My Mind After I Start Exploring This Option?

Potential donors are able to change their mind about moving forward before or after they’ve been approved. When this is the case, the reasons for donor disqualification are kept confidential. The donor’s intended recipient will only be told that the donor was not an ideal candidate, (just as they would if the donor was not medically suitable for donation). To ensure donor privacy, the transplant center does not share the reason as to why a donor was disqualified.  

10. How Will Donating a Kidney Impact Future Pregnancies or My Sex Life?

Donating a kidney has not been shown to reduce the fertility of men or women. Because the body requires time to recover from the surgery of donating a kidney, it is recommended that women wait 3-6 months after donation to get pregnant. However, a donor can engage in sexual activities after their incisions have completely healed and they feel comfortable enough to do so.

11. Are Kidney Donors Rewarded for Saving Someone’s Life?

Legally, there can be no payment given for a kidney donation. There is, however, a high value of perpetual joy that comes with saving someone’s life. Most donor’s say they never expected a financial reward. They have also said that the pride and joy they receive is priceless. Some donors have even called their kidney donation their own “Mount Everest.” Living kidney donation is a very personal experience. Because of this, not everyone can qualify to be a living kidney donor. While potential donors don’t have to be a the bravest and most heroic people on earth to consider living kidney donation, they’re dubbed as heroic, world-class humanitarians for life, post-donation.    

12. What’s the First Step To See If I Could Be A Living Kidney Donor?  

If you know someone in need of a kidney transplant, the first step would be to visit the kidney patient’s designated transplant center’s website to fill out a screening application. If the center doesn’t have an online application, simply call the center to schedule a telephone screening. If you don’t know someone in need, and want to donate altruistically, simply contact a transplant center near you.

The screening may involve questions about your health. You can also find more details about the tests involved, the surgical procedure and recovery when exploring the transplant center’s website. Even if you’re not completely sure you want to proceed with donation, this process will provide insight to help you contemplate if living kidney donation is right for you.  

All donor screen applications and conversations are handled in strict confidence to ensure your questions are answered without pressure or concern. In other words, your intended recipient will never know you’re exploring the possibility of donating until you choose to tell them directly.

Back-Up Donors Are Important Too!

If someone has been told they are not needed (at this time), but they’re still interested in donating, they can offer to be a “back-up” donor. This is invaluable, should the current donor unexpectedly change their mind or become disqualified. (Often times, it takes several potential donors to be tested before a qualified match is found).

Even after the surgery, when back-up donors are no longer needed, they can consider helping someone else. They can do this as an altruistic donor, or participate in a ‘Paired Exchange’ to help several people by becoming the missing link in a donor chain.  

How Do Living Kidney Donors Positively Impact Their Recipients Life?  

1. Living Donors Give Recipients the Ability to End Their Wait For A Deceased Donor’s Kidney:

A kidney from a living donor “Ends the Wait” for those in need of a kidney transplant. The surgery can also be scheduled when the kidney patient needs it most—and before the recipient’s health declines to a point of permanently losing their transplant eligibility.

2. Kidney Donors Offer A Better Match:

Living kidney donors are thoroughly tested to ensure the best match for their recipients. Donor testing also minimizes potential risks for both the living kidney donor and their transplant recipient.

3. Kidneys From Living Donors Function Better:

Kidneys from living donors are known to function immediately after transplant. They can also last twice as long as kidneys from deceased donors. This could potentially equate into an additional 10-12 additional years of function.

4. Living Kidney Donors Give Their Recipient an Opportunity to Bypass Dialysis (or Eliminate Their Future Need):

Since the wait for a kidney from a deceased donor can take from 3 to 9 years or more, they must be on dialysis while waiting just to stay alive. Because of this, living kidney donors can help them end their wait for a transplant and need for continued dialysis. Ideally, when the timing is right, living kidney donors allow their intended recipients to schedule their transplant before they’d require dialysis (known as a preemptive transplant).

If You’re A Kidney Patient Hoping to Find a Donor, Read On…  

Need to find a living kidney donor for your transplant—but don’t know where to start? Have you been told to ask your family and friends, but you shudder at that unimaginable “ask?”  If so, listen up!

What if you could find a way to attract potential donors without ever having to ask anyone to give up a kidney? Well, now you can—and this book will show you how!

Whether you’re trying to avoid dialysis or end your wait for a transplant, In Pursuit of a Better Life: The Ultimate Guide for Finding Living Kidney Donors is the book you need.

Inside this book for those seeking a living kidney-donor transplant, you’ll discover:

•Conversation starters
•Key talking points
•Story-scripting strategies
•Message outreach tactics
•Enlisting networking teams for story-share
•Phrasing inspirational letters, signs & cards
•Positive mindsets for promoting human kindness

Fellow kidney patient, and author Risa Simon, understands your journey more than most. As a successful preemptive transplant recipient, she shares actionable tips and meaningful insights on how to become your own best advocate and live your best life possible. The life Risa now lives.

In Pursuit of a Better Life has been called the quintessential marketing plan for engaging in these sensitive “quality of life conversations” with care, knowledge, and compassion. This book has been described as a lifesaving “game-changer” by those who uncover its proven path to preemptive (before dialysis) live-donor kidney transplants.

So, what are you waiting for? If you want to ignite your Donor-Magnet® superpowers by putting these rarely discussed before insights into action—take your hand off the “pause” button and start reading this book!

 

 

CLICK BELOW TO ORDER PAPERBACK BOOK: 

In Pursuit of A Better Life: The Ultimate Guide for Finding Living Kidney Donors

AST Releases Live Donor Toolkits

living donor toolkit

Are you (or someone you know) contemplating the possibility of becoming a living kidney donor? If so, the American Society for Transplantation (AST) just made your discovery process a lot easier. This just released, the first-ever, Live Donor Toolkit for individuals who want to learn more about living organ donation. From cost worksheets to medical implications, you’ll find it all and more in this comprehensive guide.

Living Kidney Donor Toolkit
The American Society of Transplantation Offers Medical & Financial Information.

This one of a kind toolkit was created to help interested individuals navigate complex questions surrounding financial and medical considerations involved in living kidney donation.

While a reassuring 97.5% of live organ donors say they would donate again if they could, it’s important to learn as much as you can about living donation before considering this extraordinary gift of life.

There are potential medical, psychosocial, and financial impacts associated with donating an organ. That said, interested donors need access to that information, and the best way to provide it would be in a centralized educational format. This toolkit does that and more.

AST’s educational toolkit was created specifically to improve the availability and delivery of quality education for those considering live donation. It was also created to expand living donation messaging to reach those who might consider live donation if they knew more about it. Additionally, this toolkit offers educational content that can be used across the transplant community. 

Described as being housed under two umbrellas, the Live Donor Financial Toolkit and the Live Donor Medical Impact Toolkit offer 10-15 stand-alone chapters each. As an added bonus, the Medical Impact Toolkit includes chapters written for both provider-level and patient-level comprehension.   

Here’s a sample list of chapters in the Medical Impact Toolkit:

  • Hypertension in the Living Donor
  • The Obese Kidney Donor
  • The Living Donor Who is at Risk for PKD
  • Donor Surgery – Post-op Complications
  • What is the ESRD Risk for Living Donors
  • Psychosocial Risks of Living Kidney Donation
  • Pregnancy Outcomes after Live Kidney Donation
  • Living Donation in Paired Exchange 

Here’s a sample list of chapters in the Financial Toolkit:

  • Lost wages due to recovery time
  • Missing work from the evaluation
  • Using up vacation, holiday, and sick days
  • Concerns that the employer might not support a person’s absence from work
  • Transportation for testing, surgery and follow up care
  • Travel, meals and lodging expenses  (out of town donors)
  • Related caregiver, child care, elder care, pet care costs during recovery

Click on the toolkit image below to learn more: 

Information Toolkit For Living Donors
AST’s Live Donor Toolkit Navigates Financial & Medical Questions Regarding Living Kidney Donation

 

 

 

 

 

 

 

For more information on how to share your story, increase need awareness and potentially meet individuals who might be interested in learning more about living kidney donation and/or becoming a living kidney donor for someone in need, visit: www.findingkidneydonors.com

Become A Living Kidney Donor-Magnet-Pro

Donor Magnet Pro’s are hopeful recipients and outreach teams who know how to enlighten listeners about what it takes to become a living kidney donor. This Top 12 FAQ List was recreated to help you share insights on what’s involved in living kidney donation.  

  1. Who can be a living kidney donor?

Most people in good health can be evaluated to be considered as a living kidney donor.  The qualification process typically begins with an online or telephone screening that determines if a thorough evaluation should follow. The evaluation typically includes several interviews, exams, scans and lab tests. The transplant center requires these tests to ensure the person who wishes to donate is healthy enough to do so.

  1. What does the process involve?

The Surgery:

The surgery is performed with small incisions, which is known as a laparoscopic surgery. In kidney donation (also known as a nephrectomy), the procedure typically involves four 1-inch slits in the area of the stomach and bladder. There is also one four-inch incision made around the navel. This incision is a bit larger, so the kidney can be removed from this area.

Risks:

The surgical process for removing a kidney from a healthy individual has become a fairly standard procedure. Nonetheless, the procedure still carries the same level of risk as any other major surgery. The most common risks associated with kidney donation (also known as a nephrectomy) includes blood clotting, infection and a reaction to the anesthesia. The risk of death from donating a kidney is less than one percent, or 0.0003 % (which is about 3 in every 10,000 surgeries).

Hospital Stay:

Hospital recovery usually involves 1-3 overnight stays. Discharge is determined by the donor’s health and their ability to get out of bed and walk on their own.

Discomfort:

Although the donor will feel pain after surgery, pain medications will be provided to help patient comfort. It is not uncommon for some patients to experience constipation from pain medication. When this is the case, laxatives are provided. FAQ: Understanding Living Kidney Donation. 

Most living kidney donors can resume their regular activities within 3 weeks after donation. Depending on the type of work they perform, they can often go back to work within 3-5 weeks. If the donor’s work is office work, they can often get back to work even sooner. Those engaged in more strenuous activities are advised to refrain from these types of tasks until they are completely recovered.

  1. Who is going to pay for the cost of the procedure?

The medical insurance covering the individual who receives the donor’s kidney (and kidney transplant procedure) will also cover the donor’s medical costs. Things that are not covered or paid for (by the transplant patient’s insurance company) is the donor’s time off from work and travel costs. There are a few states that now require employers to cover living kidney donor’s time off work for a set period of time. *It is wise to check with employer policies, state laws and federal updates to ensure both donor and recipient are up-to-date.

  1. Can a donor still live a normal life after surgery?

There are many studies showing living kidney donors doing quite well after they donate a kidney. For the most part, their health and quality of life remains unchanged. The most notable change expressed by most living kidney donors comes in the form of the perpetual joy they feel for achieving such an extraordinary triumph.

Living kidney donors aren’t typically required to take new medications following the surgery, other than a pain medication or a stool softener for a short period of time. Kidney donors do not need to follow a special diet after they are discharged from the hospital. Likewise, they are not required to avoid alcohol, except for the period of time they would be taking pain medication. The guideline for alcohol consumption after kidney donation is fairly standard. Living kidney donors should be simply be responsible and consume alcohol in moderation.

  1. What emotions will the donor feel before or after surgery?

Like any excursion someone has never taken before, there can be a sense of excitement and anxiety about the journey ahead. Typically, the more one understands going into the process, the less anxiety they’ll experience. Post-surgery, most donors report a feeling of honor and joy from their heroic achievement. Remarkably, their sense of joy has reduced post-surgical pain and associated inconveniences.

  1. How successful are living kidney donor transplants?

Hospitals with established transplant programs show very good transplant success rates. Most transplant centers* exceed a 95% success rate one year after transplantation. The best success rates are seen in transplants from living kidney donors. (*Transplant programs are required to keep track of their success rates. Be sure to ask the center to share their success rates).

  1. Does the age of the donor matter?

Generally, there the ideal age range is 18-65 years old. Of course, the donor will need to prove (during their evaluation) that he or she is healthy enough to donate a kidney safely. While there have been donors who have donated a kidney after the age of 65; younger donors are preferred. Family members are also preferred, as they offer a better match. FAQ: Understanding Living Kidney Donation.

  1. What happens if the donor’s kidney isn’t a blood type match?

When the living kidney donor is not a match for their intended recipient (because they are incompatible in blood type or have antibodies to the recipient) they can still donate—just not directly. This is accomplished through a Paired Exchange Program.

In Paired Exchange, a computer algorithm is used to find a better match for incompatible groupings. In this model, the living kidney donor’s kidney is swapped with another person’s incompatible living kidney donor. The picture below illustrates this concept. In this scenario, a mother hoped to donate to a daughter and a brother hoped to donate to a sister. Both were unable to donate directly because it was determined that their kidneys would unlikely function well for their intended recipients. After they were told about the Paired Exchange Program, they agreed to be matched up with other incompatible pairs. In the example below, the mother donated to the brother’s sister, and the brother donated to the mother’s daughter. Though this example shows two incompatible pairs, it is not uncommon to see a larger grouping of individuals in a chained sequence of domino-like events.

  1. What happens if a donor changes their mind? 

Interested donors can change their mind at any time about donating. Changes of this nature are kept confidential. The only information shared will be communicated as follows: “The donor was not an ideal candidate.”

  1. Will donating a kidney prevent the donor from getting pregnant or affect their sex life?

Donating a kidney has not shown to reduce the fertility of men or women. Because the body requires time to recover from the surgery of donating a kidney, it is recommended that women wait 3-6 months after donation to get pregnant. In the meantime, a donor can engage in sexual activities after their incisions have healed and they feel comfortable enough to do so.  

  1. Does a kidney donor get anything for donating?

Legally, there can be no payment for kidney donation. Though, we are told that there is high value gained in the perpetual joy that comes with saving someone’s life. Some donors explain this as their highest “life achievement.” Others have called it their own “Mount Everest.” Living kidney donation is

a very personal experience. Not everyone can be a living kidney donor. It takes a very special person to connect to this humanitarian call. It also takes a very healthy person to even qualify.  

  1. What’s the first step for someone to see if they’d qualify?

The first step is to call the kidney patient’s designated transplant center to schedule a telephone screening. During the call individuals can ask questions and get more details about the tests involved, the surgical procedure and recovery. Even if the person calling is not completely sure they want to proceed, this call can provide insight to help them decide if living kidney donation is right for them.  All donor coordinator conversations are handled in strict confidence* to ensure callers can ask questions without pressure or concern. *The recipient will never know someone called in or their status, unless they tell them directly.

You Can Also Offer To Be a Back-Up

If someone has been told they are not needed (at this time), but they’re still interested in donating, they can offer to be a “backup.” This is important, should someone unexpectedly change their mind or be disqualified. (Often times, it takes several potential donors to be tested before a qualified match is found). If individuals are told they aren’t needed following the surgery, there is another way to proceed. They can also contact a hospital that performs kidney transplants in their area and tell them they’d like to be help one of their patients in need. An altruistic offer like this can often kick-off a Paired Exchange Chain. In these types of grouped events, one living kidney donor can offer extended life to a number of people in need. They do this by providing the missing link (their kidney) to be the final piece of the puzzle that completes the chain.

Key Benefits to Receiving a Transplant from a Living Donor:

  1. Ends the Wait

A kidney from a living donor “Ends the 3-9 Year Wait” for someone in need of a kidney transplant. The surgery can also be scheduled at the donor’s convenience when the kidney patient needs it most—and before their health declines, so they are not at risk for losing transplant eligibility.

  1. Offers a Better Match

Living kidney donors are thoroughly tested to ensure the best match for their recipients. Donor testing also minimizes potential risks for both the living kidney donor and the recipient.

  1. Offers Better Function

Kidneys from living donors are known to function immediately after transplant. They can also last twice as long as a kidney from a deceased donor. This could potentially equate into an additional 10-12 + years of function.

  1. Presents an Opportunity to Bypass Dialysis

Most kidney patients need to be on dialysis (to stay alive) while they wait for a deceased donor’s kidney. Hence, living kidney donors can help those in need receive a transplant before the need for dialysis. This is called a preemptive transplant. This process allows end-stage kidney disease patients to bypass* the need for dialysis altogether. *Note: Living kidney donors must be tested and approved for the surgery before the recipient’s function drops to a level of requiring dialysis.

 

For more information on how to become a Donor Magnet Pro, visit www.FindingKidneyDonors.com 

 

Living Kidney Donation: What’s It Going To Cost?

Preparing for Potential Costs Related to Live-Donation

Studies show that living donors may spend an average of $5,000 related to their donation — these include direct and indirect costs. A strong consensus exists to support a financially neutral impact to a live organ donor’s contribution to humanity.

To that end, the Live Donor Community of Practice of the American Society of Transplantation, along with the support of eleven other organizations, looked at systemic and financial barriers to living donation and developed a toolkit to give potential living donors financial resources to assist in making informed decisions about the donation process in advance of donation.  

Areas that may financially impact living donors and care providers might include:

• The loss of wages associated with recovery time and testing procedures  

• Transportation to the transplant center for testing, surgery and follow-up care

• Food, lodging, and incidentals for donation-related visits

• Paying for alternate caregiving plans – child care, elder care, pet care

• Forfeiting vacation time, holidays, sick days or FMLA for time off work

• Denials when purchasing disability or life insurance—or paying higher premiums.

• Job security concerns for employers who may not work absences associated with donation

• Uncovered medical expenses, which may vary by transplant center and by insurance contract. *(Potential donors should explore coverage of donor complications and follow-up).

This article contains considerable content excerpts from American Society of Transplant. See full details at this link: https://www.myast.org/sites/default/files/AST-16-Financial-Toolkit-Section-Intro.pdf 

View sample cost-estimation worksheet pdf at MyAST link: https://www.myast.org/sites/default/files/AST-16-Financial-Toolkit-Section-1-Cost-Estimation-Worksheet.pdf

Financial Assistance Programs:

The National Living Donor Assistance Center (NLDAC) is a government funded program that provides financial assistance to eligible living donors for their travel expenses to the transplant center. Approved donors receive a special American Express controlled value card to pay for transportation, food, and lodging up to a total of $6,000. NLDAC will also pay for up to two trips for the donor’s support person(s). Eligibility is based on the recipient household yearly income, which should be no greater than 300% of the federal poverty guidelines (FPG). If the recipient household has an income greater than 300% of the FPG, a waiver for financial hardship may be requested. For complete 2016 information, see the NLDAC Brochure.

Learn more here: https://www.myast.org/sites/default/files/AST-16-Financial-Toolkit-Section-2-NLDAC-How-to-Apply.pdf