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    Living Kidney Donation:
    An Overview for Living Kidney Donors

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    Knowing that the gift of one’s kidney can help end dialysis treatments and enable an individual with kidney failure to enjoy more freedom and energy prompts many to consider living kidney donation.

    At California Pacific Medical Center in San Francisco, we have been performing living donor kidney transplantation since 1973. To date, we have had nearly 1,000 living kidney donors who have graciously provided the “gift of life.” Our Kidney Team works closely with all donors, beginning with the initial evaluation and continuing through surgery and follow-up visits.

    While donating a kidney can be one of life’s greatest experiences, it should be entered into with a complete understanding of the living donation process.

    What are the treatment options for someone with kidney failure?  |  What are the advantages to having a living donor transplant?  |  Who can be a kidney donor?  |  If I decide to be a donor, what should I do?  |  What happens during surgery?  |  What is laparoscopic kidney removal surgery?  |  What is recovery like?  |  What are my health risks?  |  Who pays for my medical costs?  |  Will I need follow-up care after I donate?

    What are the treatment options for someone with kidney failure?

    A patient with kidney failure can choose among two forms of treatment for this condition:

    • Dialysis
      • Hemodialysis uses a machine to filter one’s blood and temporarily remove waste products, extra salt and extra water from the body.
      • Peritoneal Dialysis uses the lining of one’s abdomen to remove waste products, extra water and chemicals from the body.
    • Kidney Transplantation is a surgical procedure that involves the replacement of a diseased, damaged or missing kidney with a healthy donor kidney. The donated kidney does the work of the two failed kidneys. There is no need for dialysis with this surgical treatment. Although most patients receive kidney transplants after starting dialysis, patients may also choose transplantation before starting dialysis. For many patients, kidney transplantation has become the preferred treatment for kidney failure.

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    What are the advantages to having a living donor transplant?

    Living donor transplantation provides some major benefits for patients. First, patient outcomes are much better than for those who receive a transplant from a deceased donor. Second, the waiting time before transplantation is usually very short. The current waiting time in California for a deceased donor organ is five to seven years, while with a living donor, a transplant could occur within a few months. Third, the operation can be timed to meet the patients’ needs, allowing them to prepare both physically and mentally for surgery.
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    Who can be a kidney donor?

    Living donors are usually between the age of 18 to 65 and in excellent health. Older donors are considered on a case by case basis. One cannot donate a kidney if he/she has suffered from diabetes, hypertension, heart disease, cancer or chronic kidney disease. A kidney donor and recipient do not need to be the same race or blood type.

    There are two types of living donors:

    • Living Related Donor: Refers to a living donor who is a healthy blood relative of the person awaiting transplant. This includes a sibling, parent, child, aunt, uncle, cousin, etc.
    • Living Unrelated Donor: Refers to a healthy person who is emotionally close to, but not blood-related to the person awaiting transplant. This includes one’s spouse, in-law relatives and close friends. A living unrelated donor may also include an altruistic donor or someone involved in a kidney paired donation or donor chain.

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    If I decide to be a donor, what should I do?

    Individuals who want to donate to someone who is awaiting kidney transplantation at California Pacific Medical Center can start the process by calling our Living Donor Transplant Coordinator at 415-600-1700. Our coordinator will then guide you through the steps to become a living kidney donor. Opens new window
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    What happens during surgery?

    The surgical procedure to remove a kidney from the donor is called a nephrectomy and takes approximately 2 to 3 hours. There are two options for kidney transplant surgery: either laparoscopic kidney removal or open surgery. Most nephrectomies are now done with the laparoscopic technique.

    Prior to surgery, the nurse will start an IV in the donor’s arm. Once the donor comes to the operating room, he/she receives a general anesthetic and quickly falls asleep. The surgeon then removes one of the donor’s kidneys. The donor and recipient surgeries are staggered so that immediately after the donor’s kidney is removed, the surgeon transplants it into the recipient, who is in an adjacent operating room.

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    What is laparoscopic kidney removal surgery?

    Laparoscopic kidney removal surgery, also known as laparoscopic nephrectomy, is a minimally invasive surgical procedure for obtaining a kidney from a living donor. In comparison to open surgery, laparoscopic nephrectomy results in a smaller incision, lessens recuperation time and shortens one’s hospital stay. Our team has been using this procedure for more than a decade.

    During the laparoscopic kidney removal, small incisions (~ 1 cm in length) are made at three key points in the abdominal area to enable insertion of instruments and a miniature camera. The camera is attached to a monitor that the surgeons view to guide their work. A slightly larger incision (~ 8 cm in length) just above the pubic bone is used to remove the donor’s kidney for transplantation.

    Typically, laparoscopic nephrectomy patients (donors) spend 2 to 3 days in recovery before being discharged, compared to an average of 5 days with the typical open donor kidney transplant surgery.



















    During laparoscopic kidney removal surgery, three small incisions below the ribs allow the surgeon to insert instruments and a miniature camera. The kidney is removed through an incision above the pubic bone.


    Medical Illustration Copyright © 2007 Nucleus Medical Art, All rights reserved. www.nucleusinc.com

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    What is recovery like?

    Living donors typically spend 2 to 3 days recovering in the hospital and can return to their normal level of activity within 4 to 6 weeks. The first few days after surgery, kidney donors are made comfortable with patient-controlled pain medicine.

    Because the kidney donor operation is a major surgical procedure, donors find they have less energy and need about 4 to 6 weeks to return to their full pre-surgical activity level.

    Before leaving the hospital, the transplant staff will schedule a 2-week follow up visit. This appointment is necessary to check the donor’s surgical incision, blood pressure and overall health. Additionally, California Pacific offers a Living Donor Wellness Clinic following kidney donation.

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    What are my health risks?

    Typically, there is little risk to a living kidney donor. Of course there is the usual risk and pain associated with any surgery, but they are usually minimal due to the excellent health of the donor. Our team will discuss medical and psychosocial risks associated with kidney donation during your evaluation. However, if you have any questions regarding the specific risks a potential donor may face, contact our Living Donor Transplant Coordinator at 415-600-1700.
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    Who pays for my medical costs?

    All expenses for the medical work-up and transplant surgery are covered by the recipient’s health insurance. In considering donation, candidates need to consider additional expenses such as:

    • Travel to California Pacific Medical Center in San Francisco
    • Parking, lodging, gas, bridge tolls and other incidentals
    • Lost wages if sick time or short-term disability from work is not available
    Our transplant financial coordinators and social workers can discuss your specific circumstances in more detail.

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    Will I need follow-up care after I donate?

    Kidney donation should not affect the donor’s life span or lifestyle once he/she has healed from the surgery. For health maintenance, the kidney team encourages regular yearly visits with your primary care physician.

    Additionally, California Pacific offers a Living Donor Wellness Clinic, which gives donors the opportunity to see a transplant team member and have an annual health evaluation following kidney donation. This visit is covered by a donor’s primary insurance or, if insurance is unavailable, by California Pacific Medical Center. Clinic visits are available at sites throughout Northern California.

    Approximately 3 to 6 months following donation, the kidney team will contact you to schedule an appointment at our Living Donor Wellness Clinic. This includes a focused physical exam, weight and blood pressure check, and blood and urine tests.

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    About California Pacific Medical Center

    California Pacific Medical Center, part of the Sutter Health Opens new window network, offers kidney, pancreas, liver and heart transplantation as part of our Barry S. Levin, MD Department of Transplant.

    Kidney & Pancreas Transplant Program
    California Pacific Medical Center
    2340 Clay Street
    San Francisco, CA 94115
    Tel. 415-600-1700

    Outreach locations available throughout Northern California and in Reno.
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