A living kidney donation saves or dramatically improves another person’s life. This voluntary act requires the donor to meet high standards of physical and psychological health to ensure the procedure poses minimal risk. The entire process, from initial screening to long-term monitoring, is governed by protocols focused entirely on the donor’s well-being. Potential donors must successfully navigate a detailed evaluation, a minimally invasive surgery, and a lifelong commitment to monitoring the health of their remaining kidney.
Initial Health and Psychological Eligibility
The journey begins with an assessment of the potential donor’s baseline health. Candidates must generally be over 18 years old to ensure they possess the capacity for fully informed consent. Major chronic diseases that could compromise the remaining kidney are considered absolute contraindications. This includes uncontrolled high blood pressure, active or recently treated cancer, and diabetes, which is an immediate disqualifier due to the long-term risk of kidney damage.
Transplant centers also use a Body Mass Index (BMI) limit, typically targeting a BMI below 35 kg/m², as higher weight increases surgical risks. A stable psychological state is equally important, confirmed through a psychosocial evaluation by a social worker or psychiatrist. This assessment ensures the decision to donate is completely voluntary, free from coercion, and that the donor fully understands the procedure’s risks and the commitment required for follow-up care.
The Comprehensive Donor Evaluation Process
Once initial eligibility is established, the candidate moves into an intensive evaluation phase. Blood samples are analyzed for ABO blood group compatibility. Detailed Human Leukocyte Antigen (HLA) tissue typing and cross-matching tests are performed to predict the recipient’s immune response to the new organ.
The donor’s kidney function is measured, often requiring two separate 24-hour urine collections to accurately calculate the glomerular filtration rate (GFR) and check for protein leakage. Imaging studies are performed to map the anatomy of the kidneys and their blood vessels, which is crucial for surgical planning. A Computed Tomography Angiography (CTA) or Magnetic Resonance Angiography (MRA) provides the surgeon with a detailed view of the renal arteries and veins, helping determine which kidney is safest to remove.
Multiple consultations form the final part of the evaluation, including meetings with a nephrologist, a surgeon, and an Independent Living Donor Advocate (ILDA). The ILDA’s role is distinct and solely focused on protecting the donor’s interests, separate from the recipient’s medical team. This advocate ensures the donor’s rights are maintained and that they can withdraw from the process at any time without pressure.
The Surgical Procedure and Immediate Post-Op Recovery
The removal of the kidney, known as a donor nephrectomy, is performed using a minimally invasive laparoscopic technique. This procedure involves several small keyhole incisions and one slightly larger incision, typically three to four inches long in the lower abdomen, through which the kidney is removed. The less invasive approach minimizes post-operative pain and shortens the recovery period compared to traditional open surgery.
Donors typically remain in the hospital for one to three days following the procedure. Immediate post-operative care focuses on pain management, often transitioning from intravenous medication to oral pain relievers within the first day. A common, temporary discomfort is referred shoulder pain, caused by the carbon dioxide gas used to inflate the abdomen during the laparoscopic surgery.
Walking is strongly encouraged within 24 hours to promote healing and prevent complications. Donors can generally return to light, non-physical work within two to four weeks. They are restricted from lifting anything heavier than a small child for approximately four to six weeks. Full recovery, where the donor returns to pre-donation strength and energy levels, usually takes between three and four months.
Life After Donation and Long-Term Monitoring
After donation, the remaining kidney naturally increases its filtering capacity, a process called compensatory hyperfiltration, allowing a person to live a normal, healthy life. Long-term systematic monitoring is required to protect the single kidney. Federal regulations mandate a formal follow-up with the transplant center for at least two years post-donation, with subsequent annual checkups recommended for the rest of the donor’s life.
These yearly appointments, often conducted by the donor’s primary care physician, focus on monitoring the health of the remaining kidney through specific tests. Checks include blood pressure measurement, a urinalysis to screen for protein in the urine, and blood tests to measure creatinine levels as an indicator of kidney function. Maintaining a healthy lifestyle is strongly emphasized, including a balanced diet, regular exercise, and maintaining a healthy weight.
Standard precautions are necessary to avoid stressing the sole kidney. Donors are advised to avoid Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen, for routine pain relief, as these medications can be toxic to kidney function over time. High-impact or contact sports like football, boxing, or martial arts are generally discouraged to prevent blunt trauma to the abdomen, which could risk injury to the remaining organ.