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Kidney transplant

Unlike many other types of organ donation, it is possible to donate a kidney while you are alive because you only need one kidney to survive. This is known as a living donation.

Ideally, living donations will come from a close relative because they are more likely to share the same tissue type and blood group as the recipient, which reduces the risk of the body rejecting the kidney. However donations from those who are not blood relatives are sometimes possible.

Kidney donations are also possible from donors who have recently died. However, this type of kidney donation has a slightly lower chance of long-term success.

Who can be a living donor?

There is no upper age-limit for choosing to make a living kidney donation, but you will usually need to be 18 or over.

If you decide to donate one of your kidneys, you will need to attend a series of appointments so that:

  • your blood group and tissue type can be determined, to check your compatibility with potential recipients (see below)
  • the state of your kidneys can be checked
  • your general health can be assessed
  • tests can be carried out to see if you have any serious illnesses that could affect the donation, such as HIV or hepatitis C

This assessment procedure can take 3-6 months, and some overnight stays at a specialist transplant centre may be required.

Checking compatibility

One of the biggest risks of receiving a donated kidney is that your immune system will mistake the donated kidney for foreign tissue. If this happens, your immune system will attempt to destroy the kidney. This is known as rejection.

To minimise the risk of rejection, the kidney should ideally be donated by a donor to a recipient who shares the same:

  • tissue type - human tissue carries a special genetic 'marker' or code, known as a human leukocyte antigen (HLA); ideally, you should receive your transplant from someone with a very similar HLA tissue type
  • blood group - as with tissue, red blood cells carry a specific antigen marker

For these reasons, family members are usually the most suitable donors. Members of the same family often share the same genes so they are more likely to have matching HLA tissue types and blood groups.

However, many kidney transplants have been successfully performed using compatible donations not taken from a family member.

Removing your kidney

Your kidney can be removed using:

  • laparoscopic (keyhole) surgery - a type of minimally invasive surgery that involves making several small incisions (cuts), through which fine instruments are used to remove the kidney
  • open surgery - where the kidney is removed through a single, larger incision

Laparoscopic surgery has the benefits of reduced scarring and a faster recovery time then open surgery, but it can only be performed by a surgeon with special expertise in the procedure so it may not always be an option.

Both types of operation are carried out under general anaesthetic, which means you will asleep during the procedure and won't experience any pain while it is performed.

See how kidney transplants are performed for information about what happens with your donated kidney once it is removed.

Recovery

You will usually need to stay in hospital for up to seven days if you have open surgery to remove one of your kidneys, whereas you can usually go home in 3-4 days after keyhole surgery.

You will need to take it easy for a few weeks after the procedure. You can usually return to work within about 3-4 weeks, but you may need more time off if you have an active and strenuous job.

Risks

As with any type of surgery, removing a kidney has risks. However, most complications associated with the procedure are relatively minor and treatable.

The most common problems that occur after the operation are infections - including wound infections, urinary tract infections and chest infections. It's estimated that about 1 in every 3 donors develop an infection of some sort after surgery.

More serious complications, such as blood clots or severe bleeding, occur in about 1 in every 100 cases. However, such problems can be identified and treated quickly.

The risk of dying after surgery to remove one of your kidneys is very small, occurring in less than 1 in every 3,000 cases.

It's important to make sure you fully understand all risks associated with kidney donation before you consent to the procedure.

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