Examination and surgery
Do you want to donate a kidney while living? Read about the examinations you will undergo at the hospital and how the surgery and recovery process works.
Examination at the hospital
Have you signed up to donate a kidney to someone? The transplant hospital will then check step by step whether you are suitable. We call this a screening.
Treatment team
In most hospitals, there is a dedicated treatment team for you, and one for the patient receiving your kidney.
A team usually consists of a living kidney donation coordinator, a nephrologist (kidney specialist), a medical social worker, and a surgeon.
At the first appointment, you usually speak with the living kidney donation coordinator. They explain:
- What examinations can you expect?
- What are the pros and cons?
- How does the surgery proceed?
- What is it like to live with one kidney?
Sometimes you will undergo some examinations during this first visit.
Questions about your physical and mental health
During the intake, you will be asked questions about your health, previous illnesses, and medication use. In many hospitals, you fill out a questionnaire in advance.
You will also have a conversation with a medical social worker. They assess whether you are emotionally strong enough and help you cope with everything that comes your way. For example, you will discuss:
- Why do you want to donate a kidney?
- How do you feel about donating a kidney?
- How do you deal with gratitude or expectations from the patient?
- What is the impact on your family or your work?
The social worker also provides practical help:
- What options are available for help at home after the surgery?
- How do you get costs reimbursed?
- What about work and leave?
Sometimes a conversation with a medical psychologist or psychiatrist follows. For example, if you have had mental health issues in the past or if you want to donate a kidney to someone you do not know. They assess whether you are choosing voluntarily and thoughtfully.
Medical examinations
This is followed by medical examinations to determine if you are physically healthy enough to donate a kidney. These include:
- Measuring your blood pressure, height, and weight.
- Examination of your blood and urine.
- ECG and an X-ray of your heart and lungs.
- CT or MRI scan of your kidneys and the blood vessels leading to the kidneys.
These examinations show, among other things, whether your blood vessels and ureters are a good match for the recipient, and which kidney is most suitable for donation. If it turns out that your kidneys are not the same size, an additional scan may be necessary. You always keep the best-functioning kidney yourself.
After all examinations, you will hear from the treatment team whether you are suitable to donate a kidney and which kidney they wish to use.
Sometimes doctors may discover an illness you were unaware of. This can have both advantages and disadvantages. You will be treated in time. However, it can be a disadvantage if you want to take out insurance or a mortgage.
In most hospitals, you will have an appointment with a surgeon and/or nephrologist before the surgery.
Who is not suitable as a donor?
Your health always comes first. These may be the reasons why you are not suitable:
- Your kidneys are not functioning properly.
- Your blood vessels are structured differently than in most people.
- Your arteries leading to the kidneys are calcified.
- You are overweight, have high blood pressure that is difficult to treat, or have diabetes.
- You have psychological issues.
Consent for donation and data collection
Your consent
Are you suitable as a kidney donor? If so, the hospital will ask for your consent and you must sign a declaration. You may take your time to think about this and discuss it with family or friends first. Even if you have already signed, you may decide later not to donate after all. That choice is always yours.
Personal dataTo make organ and tissue donation and transplantation possible, the Dutch Transplant Foundation (NTS) collects personal data. This is legally required. Asking for consent is not necessary for this. The data is used to properly organize and improve care.
Data for scientific researchYour data can also be used for scientific research. This is only allowed if you have given your consent for this yourself.
Suitable: how long to wait for a transplant?
Have you been approved as a kidney donor? Then you may sometimes have to wait a while until the transplant is scheduled. Reasons can be:
- Cross-over program
If you participate in the cross-over program, it is checked 4 times a year whether there is a suitable match with another couple. It may therefore take a while before a suitable match is found. - Kidneys are still good enough
Sometimes the recipient's kidneys still function sufficiently. In that case, immediate transplantation is not yet necessary. The doctor determines the best time for the operation together with the recipient.
The surgery
It can feel strange: before the surgery, you are healthy. As soon as you step into the hospital, you are suddenly a patient undergoing surgery.
As a donor, you are operated on first. This can be keyhole surgery or open surgery. You will always be put under general anesthesia. The surgery usually takes 2 to 3 hours.
Risks of the surgery
Mild problems that occur more frequently
- Your wound does not heal properly or becomes infected.
- Bleeding.
- Deep vein thrombosis (DVT) in the leg.
- In men: pain or swelling in the testicles.
- Pneumonia or bladder infection.
- Abdominal complaints.
- Fatigue.
Major problems that occur very rarely
- Severe bleeding.
- Pulmonary embolism: blockage in a blood vessel to the lungs.
The risk of death as a result of the surgery is extremely small.
When will you hear something about the transplant of your kidney?
Do you know the person who received your kidney? If so, the surgeon will usually tell you how it went immediately after the surgery. Often, it can be seen quickly from the recipient's blood whether the kidney is working well. You will also usually have contact or be able to visit each other within a day.
In the case of a crossover transplant or anonymous donation, there is no contact.
Back home, what now?
With a good recovery, you may go home after a few days. Listen carefully to your body and take it easy at home for a while. That can be difficult, especially if you have never been ill before.
Possible complaints shortly after the surgery:
- Nausea or vomiting (can be caused by the anesthesia).
- Pain at the wound site.
- Pain in the shoulder or diaphragm after keyhole surgery.
- Difficulty with bowel movements (constipation).
- Fatigue, concentration and memory problems.
Usually, these complaints last for a few days to weeks. You will receive medication for this. Very occasionally, you may continue to suffer from pain at the wound site or in the abdomen for longer.
Help with housework for a while
Furthermore, you must not lift, push, or pull heavy objects for 6 weeks. You might therefore need some help with housework for a while. See if family or friends can help.
Other options:
- Request domestic help through the municipality (Wmo). This is sometimes possible.
- Hire help yourself through an agency.
- Make use of the living donation expense reimbursement for the extra costs you incur.
Need help arranging this? Ask the medical social worker.
Back to work
It may take a while before you can work full-time again. This depends on your recovery and the type of work. Keep in mind that it takes 3 to 6 months before you feel completely like yourself again.
Check-ups and aftercare
Within 3 months, you will come to the hospital for a check-up. You will speak with the surgeon and the living kidney donation coordinator. They will check if you have recovered well and want to know how you experienced everything. You can also talk to a social worker. They can also help you with submitting the expense reimbursement.
Even after that, you will remain under observation at the transplant hospital or with your GP to monitor things like your urine, blood pressure, and kidney function. Your doctor will let you know how often this is necessary and where you will have the check-ups.
Costs and reimbursements
Many of the expenses you incur as a donor are reimbursed, even if the donation does not ultimately go ahead.
- Your health insurer pays for medical costs, such as screening, surgery, and check-ups. You do not pay any of your excess (deductible) for the donation.
- Sometimes you may have to spend extra money, such as on parking fees or for domestic help.
- It is also possible that you may have a temporary loss of income. There is also a reimbursement for this.
Living with one kidney
You can live perfectly well with one healthy kidney. The remaining kidney largely takes over the work.
Most donors notice no difference from how they felt before. You can simply exercise, travel, work, and resume your daily life. You do not need medication or a special diet.
It is important that you live a healthy lifestyle:
- Drink enough water.
- Eat healthily and consume little salt.
- Do not smoke.
- Preferably do not take painkillers with anti-inflammatory properties (such as ibuprofen or naproxen), as these can damage your kidney.
Before you can donate a kidney, the kidney specialist will assess your risk of future kidney problems. This is because you will only have one kidney left, and it must continue to function well. If that kidney starts to function less effectively, it is called kidney failure.
Priority on the waiting list
If you need a donor kidney yourself due to kidney failure, waiting list for a kidney from a deceased donor. This applies to donors who have previously donated a kidney to someone living in one of the countries affiliated with Eurotransplant.
Note: just like others, you will only be placed on the waiting list if medical examinations show that a transplant has a good chance of success for you.