Living Donor Organ Transplantation
Most kidneys and livers used in transplantation come from deceased donors, but this approach doesn’t provide enough organs for all the people who need them. More than 113,000 people in the United States are waiting for an organ. Many of them will wait years for a life-saving organ transplant. That’s why it’s essential to increase the number of liver and kidney donations from people who are alive.
You can save a life and gain a wonderful sense of satisfaction by becoming a living organ donor.
“Our philosophy is that people should be as healthy after donating a kidney as before,” says Sanjay Kulkarni, MD, medical director of Yale Medicine and Yale New Haven Hospital Center for Living Organ Donors at Yale New Haven Health. The center builds support communities for donors and is a pioneer in providing free, lifelong local medical monitoring for any issues that may arise related to their organ donation.
What is a living organ donation?
A living donation occurs when a person who is alive donates an organ—a liver or a kidney—so that it can be transplanted into someone who needs it. For the recipient, there are many benefits to living donation, including a shorter wait for an organ, convenient scheduling of surgeries, and fewer complications and procedures (including dialysis for a kidney recipient). In addition, once they are transplanted, organs from living donors often last longer than those from deceased donors.
A transplant is possible when the donor and recipient are compatible, which may include such factors as blood type and body size.
There are three types living donations:
Directed donation: You donate your organ to a specific person—either a family member, someone you know or a stranger you have heard about.
Non-directed donation: You donate an organ, but do not name a specific recipient. Your transplant center gives the organ to a medically-compatible recipient.
Paired donation: You want to donate a kidney to a loved one, but you are not compatible, so you “trade” with another donor/recipient pair. Their recipient gets your kidney and your loved one gets their donor’s kidney. A paired donation can involve multiple donors and recipients.
Who can be a living donor?
Most people older than 18 can be living donors, and in some cases surgeons will consider donors who are 65 or older. Some health conditions may prevent you from being a living donor, so a transplant surgeon will want a full medical history, as well as a blood test.
If you qualify as a donor, it is important that you make an informed decision. Your doctor should make sure you fully understand the donation process and are aware of the risks.
You should think not only about health risks, but also about the impact your donation will have on your family, your finances (if you need to take time off from your job), and other areas of your life. You should never feel pressure to be a donor, and you have the right to stop the process at any time right up to the day of surgery.
What is surgery like for a kidney donor?
Today, many kidney donors have minimally invasive laparoscopic surgery that involves small incisions and quick recovery times. After one kidney is removed, the other kidney will do the work of two kidneys.
During the surgery, you and your recipient will be placed in adjoining operating rooms. Your doctor will transplant your kidney into the body of the recipient, where it should begin to function immediately.
What is surgery like for liver donation?
Liver donation is more complex than kidney donation. It requires major abdominal surgery. While we have only one liver, it is possible to donate a section of it.
As a liver donor, you and your recipient will be in adjoining operating rooms. The surgeon will remove a section of your liver and the recipient’s entire liver, and then transplant your section into the recipient’s body. Over time, both people’s livers will regenerate to a normal size.
The liver’s ability to regenerate means one donation can sometimes be divided and used to save more than one life. Yale Medicine’s transplant surgeons are skilled in dividing a portion of a donor’s liver between two recipients. Our Pediatric Liver Transplant Program works with such innovative treatments as reduced liver transplants, in which an infant or child receives a portion of an adult liver.
As in a kidney donation, a liver donor must be compatible with the recipient in such factors as blood type and body size.
What is recovery like?
It’s important to talk to your surgeon about donor surgery and recovery, since experiences vary. Organ donations involve surgery and anesthesia, which carry such risks as pain, infection and blood loss.
Kidney donation is less complicated than liver donation, so both hospital stay and recovery will be longer for a liver donor than for a kidney donor. While you recover, there will be restrictions on lifting things initially and you probably won’t be able to drive right away.
While the long-term risks of kidney and liver donation are considered low, there is limited data. Lifelong follow-up is critical for early diagnosis and treatment if a problem surfaces, says Dr. Kulkarni. Unfortunately, many patients don’t stick to the recommended six-month, one-year and two-year medical follow-up schedule.
How is Yale Medicine unique in its approach to caring for living donors?
Yale Medicine is a pioneer in the field of living organ donation. We are the first academic medical practice in the country to provide community-based support and free lifelong medical monitoring for any health issues that may arise related to their organ donation. Each year, our donors can attend annual gatherings in their own communities, where they receive ongoing health education, medical monitoring for donor-related issues, and moral support from our staff and people from their communities.
David Mulligan, MD, director of the Yale New Haven Transplantation Center, says living donation will be a key element in the future of transplant surgery. Yale Medicine is committed to providing donors with all of the support they need.
“It is our responsibility to make sure these donors—these heroes—are taken care of,” Dr. Mulligan says. “We’re going to be here for them at any time in their life.”
How do I become an organ donor?
For more information about becoming a living donor, you can contact the Yale New Haven Transplantation Center at 866-925-3897.