Examination and surgery
Do you want to donate a kidney while living? Read about what tests you will undergo in the hospital and how the surgery and recovery proceed.
Examination in the hospital
Have you registered to donate a kidney to someone? Then the transplant hospital will check step by step whether you are suitable. We call this a screening.
Treatment team
In most hospitals, there is a separate treatment team for you, and one for the patient who will receive your kidney.
A team usually includes 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 already undergo a few examinations during this first visit.
Questions about your physical and mental health
During the intake, you will be asked questions about your health, past 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 coming your way. For example, you discuss:
- Why do you want to donate a kidney?
- How do you feel about donating a kidney?
- How do you deal with the patient's gratitude or expectations?
- What is the impact on your family or your work?
The social worker also helps you practically:
- What options are available for help at home after the surgery?
- How do you get costs reimbursed?
- How does it work with work and leave?
Sometimes you will have a conversation with a medical psychologist or psychiatrist. For example, if you have had psychological issues in the past or if you want to give a kidney to someone you don't know. They assess whether you are making a voluntary and well-considered choice.
Medical examinations
This is followed by medical examinations to determine if you are physically healthy enough to donate a kidney. Including:
- Measuring your blood pressure, height, and weight.
- Blood and urine tests.
- Electrocardiogram (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 of equal size, an additional scan may be necessary. You always keep the best-functioning kidney yourself.
After all the examinations, the treatment team will let you know if you are eligible to donate a kidney and which kidney they want to use.
Sometimes doctors may discover an illness that you were not aware of. This can have 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 another 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 eligible:
- Your kidneys are not functioning properly.
- Your blood vessels run 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 complaints.
Consent for donation and data collection
Your consent
Are you suitable as a kidney donor? Then the hospital will ask for your consent and you must sign a declaration. You can take your time to think about this and discuss it first with family or friends. Even if you have already signed, you may later decide not to donate after all. That choice is always up to you.
Personal data
To 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 healthcare.
Data for scientific research
Your 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 transplantation?
Have you been approved as a kidney donor? Then you sometimes have to wait a little while until the transplantation is planned. 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 are still working sufficiently. Then direct transplantation is not yet necessary. The doctor determines together with the recipient what the best moment is for the operation.
The surgery
It can feel strange: before the operation you are healthy. When you walk into the hospital you suddenly become a patient undergoing surgery.
As a donor, you are operated on first. This can be keyhole surgery or open surgery. You are always put under general anesthesia. The operation 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.
- Thrombosis 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 do you hear something about your kidney transplantation?
Do you know the person who received your kidney? If so, the surgeon will usually tell you how it went immediately after the operation. It is often quickly apparent 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 cross-over transplantation or anonymous donation, there is no contact.
Back home, and then?
If you recover well, you can go home after a few days. Listen carefully to your body and take it easy at home. That can be difficult, especially if you have never been ill before.
Possible complaints shortly after the operation:
- Nausea or vomiting (can be caused by the anesthesia).
- Pain at the wound site.
- Pain in the shoulder or diaphragm after laparoscopic surgery.
- Difficulty pooping (constipation).
- Fatigue, concentration, and memory problems.
Usually these complaints last a few days to weeks. You will receive medication for this. Very occasionally, you may continue to experience pain at the wound site or in the abdomen for a longer period.
Help with housekeeping for a while
Furthermore, you must not lift, push, or pull heavy objects for 6 weeks. Therefore, you may need some help with housekeeping for a while. See if family or friends can help.
Other options:
- Apply for domestic help through the municipality (Wmo). This is sometimes possible.
- Hire help yourself through a company.
- Make use of the expense allowance for living donation for any extra costs you incur.
Need help arranging this? Ask the medical social worker.
Returning to work
It may take a while before you can work full-time again. This depends on your recovery and the type of work you do. Keep in mind that it takes 3 to 6 months to feel completely like your old self again.
Check-up and aftercare
Within 3 months you will have a check-up at the hospital. 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 submit the expense allowance.
Even after that, you will remain under control at the transplant hospital or your general practitioner to examine your urine, blood pressure, and kidney function, among other things. Your doctor will let you know how often this is necessary and where you will have the check-up.
Costs and reimbursements
Many of the expenses you incur as a donor are reimbursed, even if the donation ultimately does not take place.
- Your health insurer pays the medical costs, such as the screening, surgery, and check-ups. You do not pay anything from your own deductible for the donation.
- Sometimes you have to spend extra money, such as on parking costs or for domestic help.
- It is also possible that you will have a temporary reduction in income. There is also compensation for this.
Living with one kidney
You can live just fine with one healthy kidney. The remaining kidney largely takes over the work.
Most donors notice no difference from how they felt before. You can just exercise, travel, work, and resume your daily life. You do not need medication or a special diet.
It is important to live a healthy lifestyle:
- Drink enough water.
- Eat healthily and consume little salt.
- Do not smoke.
- Preferably avoid painkillers with anti-inflammatory properties (such as ibuprofen or naproxen), because they can damage your kidney.
Before you can donate a kidney, the nephrologist assesses your future risk of kidney problems. After all, you will only have one kidney left, and it needs to keep working properly. If that kidney starts to function less well, it is called kidney failure.
Priority on the waiting list
If you ever 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.
Please note: just like anyone else, you will only be placed on the waiting list if medical examinations show that a transplantation has a good chance of success for you.