Frequently asked questions about living kidney donation

For most donors there is a personal reward that results from the act of giving the precious gift of good health to someone with kidney failure. Without kidney transplantation, there will be no hope for recovery of kidney function. How fortunate it is that your generosity and today’s medical science make this form of transplantation successful in over 90% of the recipients. 

For the recipient, there are many benefits, including a high success rate, a low complication rate, the ability to plan for the transplant procedure, and, most importantly, the opportunity for a healthier, happier life with your kidney.  Experience has shown that long after kidney donation, our living donors continue to feel internally rewarded.

There are 3 kinds of living kidney donations: direct, paired exchange and altruistic, or “non-directed.” Sentara’s Transplant Center can help facilitate all 3 types of donations.

• Direct kidney donation: If you know your recipient, you can donate your kidney “directly” to that person. The best direct donors are related to family members. Relatives have the best chance of being genetically compatible with each other, which means the kidney has a better chance of succeeding after transplantation.
• Paired-exchange kidney donation: If you are not a compatible donor for your intended recipient, you can do what is called a “paired exchange.” With the help of organizations like the National Kidney Registry, you donate a kidney in “exchange” for another individual donating a compatible kidney for your loved one or friend. Learn more about paired-exchange kidney donations.
• Altruistic, or non-directed, kidney donation: You may choose to donate a kidney, even though you do not have a friend or loved one who is currently in need. Perhaps someone in your life had kidney disease and was helped by a transplant. Or maybe you wanted to be a donor for someone else in the past and were not compatible. Whatever your reason, you can donate a kidney anonymously. Or you may choose to meet your recipient (if they agree) after a one-year waiting period.

We understand you may have concerns about the risks associated with kidney transplant surgery. At Sentara, we always prioritize your health over your ability to donate a kidney. Before you become a kidney donor, we perform several tests to ensure that you are in good health and have two healthy kidneys.

Although serious complications can occur from any major operation, life-threatening complications from kidney donation are rare. You will not be allowed to donate if your evaluation reveals that you have risk factors that may lead to complications from surgery or if there are risks of developing kidney problems in the future.

People can live normally with one kidney and resume all their normal activities without restriction after the recovery from the donation procedure. Most insurance companies do not restrict the ability to obtain insurance coverage after you have become a donor.

We also encourage you to ask as many questions as necessary to be sure you understand any potential risks. 

• You can live with one kidney: People with one kidney seem to experience no more health problems than those with both kidneys. After you recover from surgery, you do not need to take any special medication, follow a strict diet or anything else out of the norm.
• We put you through rigorous testing: Before you can become a kidney donor, we perform numerous medical tests to ensure you are in good health and have two healthy, functioning kidneys. If we have any questions about your ability to withstand surgery, we will not approve you as a donor. This is for your own safety.
• Life-threatening complications from kidney donation are rare: Kidney donation is now a very common procedure, and most donors tolerate it quite well. Of course, serious complications can occur whenever you undergo major surgery. However, Sentara’s experienced medical team and advanced facilities mean you are in the best possible hands.
• Health insurance eligibility is not usually affected: Most kidney donors have no difficulty qualifying for health insurance coverage after they become kidney donors.

The transplant center covers the cost of most medical testing and appointments with physicians. During the evaluation process, if a pre-existing condition is identified that requires further evaluation, the donor will be responsible for the costs associated with this condition. 

The actual costs of your hospital admission and surgery, should you be selected as a kidney donor, will be covered in part by both the recipient’s health insurance and the transplant center.

At the time that you express an interest in being considered for kidney donation, you will be interviewed by one of the transplant coordinators, who will ask questions about your medical history and demographics. This coordinator will also answer all your questions and guide you through the process, from the initial phone call or meeting to the transplant itself.

There are many aspects to your evaluation as a potential living donor, and there can be many reasons why you may be turned down as a donor, even if you volunteer. Our top priority is your health and safety.

All discussions and test results are held in confidence by the medical team members and are not shared with your potential recipient at any time. The decision to donate a kidney is a voluntary and informed choice. Should you decide at any point against donation, the transplant team will respect the privacy of your choice.

As a donor, you must initiate the first contact with the transplant center regarding your interest in being a living donor. The transplant coordinator will conduct an initial screening, either by phone or in person, which will include questions regarding your medical history and demographics. You may be excluded as a donor without further testing if you have a medical history of diabetes, high blood pressure, heart disease, or if you are at risk of developing kidney disease in the future.

Complete our living kidney donor online form

Your initial donor screenings will help determine if you are a good match. Here's what you can expect:

• Confidentiality: Be assured that anything you say to our transplant coordinator, as well as the results of your medical tests, is confidential. None of your private information will be shared with your possible kidney transplant recipient. Also, if you change your mind about donating a kidney at any point, we will respect your choice. Donating a kidney is a major decision.
• High-risk factors: If you have a medical history of diabetes, high blood pressure or heart disease or are at risk of developing kidney disease in your future, you will not be eligible to donate your kidney. Otherwise, you will continue to the subsequent phases of donor evaluation.
• Blood tests: If your first screening indicates that you are healthy, we will arrange for you to undergo initial blood tests. We need to ensure that your blood type (A, B, or O) is compatible with that of the intended recipient.
• Tissue and cross-match testing: If your blood type is compatible with the potential kidney recipient, we will then take samples and check for a body tissue match between the two of you. The “cross match” is the most crucial test of all. During this test, your blood and the recipient’s blood are mixed to ensure they are compatible with each other. If these tests are positive, you will proceed to the next steps.

Once you have completed the initial kidney donor screening and compatibility testing, we will begin your detailed evaluation.

• Meet with Sentara’s donor advocate, donor social worker, and living donor transplant coordinator. These professionals will thoroughly explain the kidney donation process. They will also provide you with a copy of the surgical consent form and the evaluation consent form to sign.
• Begin your clinical testing: We will ask you to undergo additional testing. After we get your test results, we will review them with you and discuss next steps.
• Undergo a CT scan of your kidneys: The CT (computerized tomography) scan helps us examine your kidneys more closely to ensure they are both normal in appearance and anatomy. Women may also undergo a PAP smear and mammogram.
• Undergo a comprehensive physical examination and meet with a nephrologist (a specialist in kidney care). If we identify any medical conditions during this process that require further testing or treatment, we will notify you. You may need to bill those tests or treatments to your own health insurance, particularly if the condition has been previously diagnosed.
• Meet with the transplant urologist: If you make it this far, you will have reached the final step before surgery. The transplant urologist is the surgeon who will remove your kidney. Our experienced urologist will review your medical records, explain the kidney transplant procedure and its risks and answer any questions you may have.