As the transplant waiting list continues to grow, many patients are choosing to pursue the option of a living donor transplant. Living donation happens when a living person donates one of his or her kidneys to someone in need.

Donating a kidney is a safe and successful procedure, and has many advantages, although it may not be for everyone.

What are the kidneys?

Most people have two kidneys. They are reddish pink in colour, shaped like kidney beans and are located underneath your ribs on either side of your spine. They are about the size of a clenched fist.

Why are the kidneys important?

Our kidneys are very important organs. Some of the things they do include:

Why do kidneys fail?

Kidney failure occurs when the kidneys cannot carry out their normal functions. There are many reasons why this happens.

Acute kidney failure occurs when the kidneys fail temporarily. Kidney function typically returns to normal. However, kidney dialysis may be required for a short time.

Chronic kidney failure occurs when there is a slow deterioration of the kidneys. When kidneys function at less than 10% of their normal rate, the result is called end stage renal disease, or E.S.R.D. There are many reasons why kidneys fail, including prolonged high blood pressure, and diabetes. Kidney failure is a life-threatening condition that requires treatment.

What are the treatments for kidney failure?

In the early stages of kidney failure, special diets or medication may be the only treatment required. However, when E.S.R.D. is reached, either transplantation or dialysis is required, as there is no cure for chronic kidney failure.

What is dialysis?

There are two types of kidney dialysis: hemodialysis and peritoneal dialysis. Hemodialysis cleans the blood by filtering it through an artificial kidney machine, removing excess water and wastes. Peritoneal dialysis cleans the blood using special dialysis fluids that are placed into the peritoneal (abdominal) cavity. Both methods of dialysis require some restrictions to lifestyle.

What about kidney transplantation?

Kidney transplantation is a routine and successful treatment for kidney failure. The kidney transplant waiting list is growing quickly, and people are waiting up to five years for a transplant. Due to this prolonged wait, there is an increased demand for donated kidneys. A kidney transplant provides a patient with the best chance to return to a normal life, free from the restrictions of dialysis. Donated kidneys come from two sources: cadaver donors and living donors.

Cadaver kidneys come from people who have died and either previously signed an Organ Donor Registration card and/or whose families have consented to organ donation.

Living donor kidneys come from people who have generously chosen to donate one of their healthy kidneys to a recipient (person with E.S.R.D.) who is well known by the donor. Typically, the donor and recipient are family members, close friends, or partners.

Why do people choose to become living kidney donors?

A person can live a completely normal life after donating a kidney as the remaining kidney increases its workload and easily functions as two normally would. More and more people area choosing to become living kidney donors. A living donor transplant allows a loved one to become transplanted faster than waiting for a cadaver donor kidney, and return to a normal life, free from dialysis. People who receive a kidney from a living donor have a better chance for a successful transplant, and the transplanted kidney tends to function better over time. After donating, most donors say that it was personally a very rewarding experience and that they experienced no long-term complications following the procedure.

How do you know it is safe for a person to donate a kidney?

A kidney donor must be absolutely healthy, and therefore, must complete an extensive assessment to ensure that risks to them are minimal, and to maximize the chances of a successful transplant. The majority of the assessment can be done in the potential donorís community.

What does the assessment process consist of?

The assessment process consists
of four stages:

1. Compatibility bloodwork
This is to ensure the donor and recipient are compatible by looking at blood types, antibodies, and to rule out potential donor viruses such as Hepatitis or HIV.

2. Laboratory and x-ray studies
This stage consists of doing further laboratory tests such as bloodwork, blood pressures, urine collections, an electrocardiogram (ECG), and a chest-xray to ensure that the donor is healthy. An ultrasound will also be done to assess the health and function of the kidneys.

3. Consultations with the living donor transplant team
Members of the transplant team include a transplant nephrologist (kidney specialist), transplant surgeon, clinical coordinator/nurse clinician, social worker, and psychologist. The potential donor must travel to Vancouver or the nearest transplant centre for these consultations.

4. Renal angiogram
The final test is a renal angiogram which is performed to look at the blood vessels of the kidneys. This is done only when all other tests show that the potential donor is healthy and willing to proceed with the donation.

The assessment process is designed to ensure that the physical and psychological risks to the potential donor are thoroughly explored. The safety and health of the donors are our greatest concerns, and a potential donor may be excluded if it is believed that they are at increased medical or emotional risk.

What are the risks of donating a kidney?

Donating a kidney is major surgery. The risks include: the possibility of infection, allergic reactions to general anaesthesia, pneumonia, and the formation of blood clots. The risk of dying from donating a kidney is extremely small (less than 0.03%). Although the predicted outcome of a living donor transplant is excellent, there is a small risk that following the surgery, the recipient may lose the kidney due to non-function or irreversible rejection. If this happens, the donor and recipient can feel guilt, sadness, loss, and anger.

What about the recovery time after the surgery?

The recovery time is approximately 6 to 8 weeks. Different individuals recover at different rates, and some may take shorter or longer to fully recover from the surgery. If the donor has a physically demanding job, a longer period of time off work may be required.

Who covers the costs of being a living donor?

Medicare covers the medical costs of the assessment such as lab-work, team consultations, and the surgery, even if the potential donor lives outside the province of British Columbia. If a donor lives outside of Canada, some of the assessment can be completed in their home country. Donors might be eligible for the Living Organ Donor Expense Reimbursement Program, implemented to reimburse donors for direct costs associated with the donation process. For more information please contact your Social Worker at BC Transplant.

What about other financial considerations related to becoming a donor...if I have a job?

Many people who donate a kidney are eligible for employment insurance, short-term disability leave, extended benefits, vacation days, or sick time from work. Check with your employer to determine your eligibility or speak with your BC Transplant Social Worker.

How do I become a living kidney donor?

If you or anyone you know is interested in receiving more information about becoming a living kidney donor, please call one of the two living donor kidney programs in BC: Vancouver General Hospital: 604-875-5182; St. Paul's Hospital: 604-806-9027. The Clinical Coordinator for the Living Kidney Donor Program will answer any questions you have and can help you get started with the assessment.

Thank you for your interest in the Living Kidney Donor Program

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