Risks

The risks associated with living-organ donation include both short- and long-term health risks associated with the surgical procedure, organ function and psychological problems following organ donation.

For the organ recipient, the risk of transplant surgery is usually low because it is a potentially lifesaving procedure. But donating an organ can expose a healthy person to the risk of and recovery from unnecessary major surgery.

Immediate, surgery-related risks of organ donation include pain, infection, hernia, bleeding, blood clots, wound complications and, in rare cases, death.

Long-term follow-up information on living-organ donors is limited, and studies are ongoing. Overall, available data shows organ donors fare very well over the long term.

Donating an organ may also cause mental health issues, such as symptoms of anxiety and depression. The donated organ may fail in the recipient and cause feelings of regret, anger or resentment in the donor.

The known health risks associated with living-organ donation vary according to the type of donation. To minimize risks, you'll need to have extensive testing to ensure you're eligible to donate.

Kidney donation risks

Living-donor kidney transplant is the most widely studied type of living-organ donation with more than 50 years of follow-up information. Overall, studies show the life expectancy for those who have donated a kidney is the same as for similarly matched people who haven't.

Some studies suggest living kidney donors may have a slightly higher risk of kidney failure in the future. But this risk is still smaller than the average risk of kidney failure in the general population. Specific long-term complications associated with living kidney donation include high blood pressure and elevated protein levels in urine (proteinuria).

Liver donation risks

The risks of living liver donation also are low, but experience with this procedure is more limited because it was introduced into medical practice more recently than kidney donation. The first living-donor liver transplant was performed in 1989.

As with any surgical procedure, living liver donation may involve surgical complications, such as infection, bleeding, blood clots and, in rare cases, death.

Living liver donation may also cause bile leakage, narrowing of the bile duct, intra-abdominal bleeding and, in rare cases, inadequate growth of the remaining part of the liver.

How you prepare

Making an informed decision

Making the decision to donate an organ is a personal one that deserves careful thought and consideration of both the serious risks and benefits. Talk through your decision with your friends, family and other trusted advisers.

Making the decision to donate is an individual one. You should not feel pressured to donate, and you may change your mind at any point.

Some helpful questions to consider:

• How do I feel about organ donation?
• What are the medical risks?
• What will my insurance cover?
• How will donating affect me financially or my ability to work?
• Do I know enough to make an informed decision?
• Is someone pressuring me psychologically to be a living donor?
• How will donating or not donating affect my relationship with the recipient?
• Is there someone else who could donate?
• If there is more than one possible donor, how will the living donor be chosen?
• How does my religion view organ donation?
• Are there aspects of my health or medical history that I know should keep me from donating?
• Do I have a support network in place to help me through this process?
• How will I feel if I am rejected during the evaluation process?
• How will I feel if my recipient does not do well after the transplant?

Your medical information is kept confidential by the transplant center. If you are rejected as a donor during the evaluation process, the donor is told only that your organ was declined. It is up to you whether you tell the recipient (if known) the reason if you chose to do so.

The Centers for Medicare and Medicaid Services and the Organ Procurement and Transplantation Network (OPTN) require that living-donor transplant centers provide an independent living-donor advocate to protect the informed consent process. This advocate is often a social worker or counselor who can help you discuss your feelings, answer any questions you have and assist in protecting your best interests throughout the donation process.

Choosing a transplant center

Your physician or your recipient's physician may recommend a transplant center for your procedure. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.

When considering a transplant center, you may want to:

• Learn about the number and type of transplants the center performs each year
• Ask about the transplant center's organ donor and recipient survival rates
• Compare transplant center statistics through the database maintained by the Scientific Registry of Transplant Recipients
• Assess the center's commitment to keeping up with the latest transplant technology and techniques, which indicates that the program is growing
• Consider additional services provided by the transplant center, such as support groups, travel arrangements, local housing for your recovery period and referrals to other resources

If you're committed to donating an organ, your transplant team will partner with you and your local health care provider throughout the living-donor transplantation process.

Overview

A nondirected living donor is a living person who donates an organ, usually a kidney, and does not name or have an intended recipient. The organ is donated as a gift with no expectations of return and no connections between the donor and transplant recipient.

Nondirected donors are also referred to as good Samaritan or altruistic donors. The transplant recipient is determined by medical compatibility and need.

A nondirected living donor may also participate in paired organ donation or organ donation chains to help match incompatible pairs. This process often results in a chain of transplants with multiple candidates benefiting from the nondirected donor's gift.

Why it's done

Nondirected living organ donors have become increasingly important in recent years to meet a growing need for organs for transplant and fill a shortage of available organs from deceased organ donors.

Nondirected living organ donors are often vital to linking several pairs of incompatible donor and recipient pairs to form a donation chain.

Like other types of living-donor organ transplant, nondirected living-donor organ transplant offers several benefits to the donation recipient, including less time spent on a waiting list, fewer health complications before transplant because of the shorter wait, and better survival rates after transplant.

What you can expect

To become a nondirected living organ donor, your transplant center will evaluate your overall health and perform several tests to determine your eligibility as a living organ donor.

The vast majority of nondirected living organ donations involve donating a single kidney. It is possible to donate a portion of your liver as a nondirected living organ donor, but this is extremely rare because of the risk the procedure may pose to the donor.

Once approved as a donor, your procedure will be scheduled, and the organ will be placed for distribution through the established organ allocation system.

The donated organ will be matched with a transplant candidate based on several factors, including organ compatibility, medical need and waiting list status.

If the transplant center's policy allows it and the recipient agrees, you may choose to meet the recipient or remain anonymous.