Living kidney donation
Information for people considering living kidney donation.
Most people have two well-functioning kidneys. By donating one of your healthy kidneys, you give a kidney patient a chance at a better quality of life. Read about what is involved if you are considering this yourself.
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How important are your kidneys?
Kidneys have important functions for your body, such as:
- Removing waste products from your body.
- Regulating the balance of water and salt in your body.
- Regulating your blood pressure.
- Helping with the production of red blood cells.
- Ensuring strong bones through a good balance of calcium and phosphate.
There is a connection between the functioning of your kidneys and your heart. Kidney damage can increase your blood pressure and causes waste products to accumulate in your blood. This puts extra strain on your heart and blood vessels and increases the risk of cardiovascular disease.
What if the kidneys no longer function properly?
If the kidneys no longer function properly, they can no longer perform these tasks well, and waste products remain in your body. This can lead to kidney failure: the kidneys stop working almost entirely. Dialysis or a kidney transplant is then often necessary.
What is dialysis?
With dialysis, a machine takes over the function of the kidneys. The blood is artificially cleaned. Patients often receive dialysis several times a week. This is time-consuming and works much less effectively than real kidneys. Dialysis also does not take over all the functions of the kidneys. As a result, many people feel tired or ill. Working or going to school can be difficult. Eventually, dialysis no longer works well enough.
When is a kidney transplant appropriate?
In a kidney transplant, a kidney patient receives a donor kidney from someone who has passed away or from a living donor. Before a patient receives a kidney from a deceased donor, there is usually a period of dialysis beforehand. With a kidney from a living donor, dialysis has usually not yet started.
After a kidney transplant, most patients quickly feel better than they did before the surgery. They have more energy. However, a kidney transplant is not possible for everyone. For example, you may be too ill for the surgery. It can also take a long time before there is a donor kidney that is a good match for the patient.
Read also: on the waiting list for a donor kidney
Who can become a kidney donor?
You cannot simply give a kidney to someone else. There are legal rules. You will also undergo examinations to see if you are physically healthy enough and if you can handle the donation well psychologically.
General conditions
- You are 18 years of age or older.
- You can clearly explain your wish to donate and have discussed this with others, such as your family or your GP.
- You have decided to give a kidney voluntarily. No one has pressured you, and you will not receive any money for it.
- You are physically healthy and in good condition.
- You are psychologically and socially stable.
- You do not have diabetes, kidney disease, blood disease, liver disease, or blood clotting problems.
- You do not have risk factors or a (hereditary) disease that might cause your kidneys to function worse later on. The kidney you keep must continue to work well enough for the rest of your life.
- You are not pregnant.
Up to what age can you donate a kidney?
There is no fixed age limit for living kidney donation. Even if you are a bit older, you can still donate a kidney. The hospital will then assess whether you are fit enough for the surgery and whether your kidney is suitable for the recipient.
Is your kidney a match for the recipient?
To see if donation is possible, tests are required. The doctors check whether the blood types are compatible, whether the recipient produces antibodies, and whether the tissues match. Read more about this below.
Do the blood types match?
Your blood type and the recipient's blood type must be compatible. That does not mean they have to be exactly the same.
| Your blood type | You can donate to |
|---|---|
| A | A or B |
| B | B or AB |
| AB | AB |
| O | A, B, AB or O |
The rhesus factor (positive or negative) does not matter in this case.
Sometimes direct transplantation is still possible if the blood types of the donor and the recipient do not match. The recipient then receives extra medication before the transplantation to remove the antibodies from the blood. This is called ABO-incompatible transplantation.
Does the recipient produce antibodies?
To assess whether direct donation is possible, the hospital tests whether the recipient has antibodies against your kidney. Antibodies are substances in the blood that destroy cells that do not belong in the body.
The test they perform is called the crossmatch. They take a blood sample from you and the recipient. In the laboratory, they examine whether the recipient has antibodies against your kidney. In the event of a strong immune response (positive crossmatch), there is a very high chance that the kidney will be rejected. In that case, direct donation is usually not possible.
Sometimes transplantation can still proceed after a special treatment. This is called desensitization. The recipient receives medication 1 to 2 weeks before the transplantation that removes antibodies from the blood. This is called crossmatch-incompatible transplantation. This treatment is only performed at the Erasmus MC in Rotterdam.
It is an intensive and expensive treatment, and the medication can cause side effects. Therefore, it is always first checked whether you can participate in the cross-over program.
Do the tissues match?
Another examination is tissue typing (HLA typing). This involves a blood test to see how well the donor's tissue matches that of the recipient.
To whom can you donate a kidney?
You can donate a kidney while living to someone you know, for example your partner, child, family member, or friend. But you can also donate to someone you do not know. Or you can participate in the cross-over program for couples.
Donating to someone you know
Many people donate a kidney to someone they know. This can affect your relationship with each other. That is why it is good to talk about this before the donation. Clearly express your expectations to one another. For example, do you expect the recipient to live a healthier life or enjoy life more from now on?
Sometimes there are multiple people willing to give a kidney to the same recipient. The hospital then takes several factors into account to determine who is the best match.
Donating to someone you do not know
Do you want to give a kidney to someone you do not know? That is called an altruistic donor. You donate anonymously: the donor and the recipient remain unknown to each other. Is this something for you? Then you can register at a transplant hospital (UMC). Your kidney will then go to someone on the waiting list. As an altruistic donor, you can also participate in the cross-over program.
You can also respond to a call on social media or in the newspaper for a kidney donor. Important is:
- The donor may not receive money for the donation.
- The recipient makes contact with the donor themselves before contacting the transplant hospital.
If more people respond to the call, the hospital, in consultation with the recipient and donors, determines who will be examined further first.
Exchanging with another couple: cross-over
Do you want to give a kidney to someone you know, but it is not possible because, for example, the blood type or tissue characteristics do not match? Then the cross-over program can help.
This is an exchange program where a kidney patient from another couple receives your kidney. And at the same time, the kidney from their donor goes to the recipient you wanted to help. Many people experience this as a valuable way of donating. They still feel connected to the person they wanted to help.
More about cross-over
Weighing pros and cons
Giving your kidney to someone else is a beautiful gesture. But there is also a lot involved. View the pros and cons to make a well-informed decision.
Pros
For the recipient of your donor kidney, there are advantages compared to a kidney from a deceased donor.
A better life for someone else
You give someone a better life. This means a lot to this person. You also help the people around the patient. Are you giving a kidney to your partner or family member? Then life often becomes calmer and more normal for all of you again.
Do kidney diseases run in your family? Then think carefully about the timing and who you give your kidney to. You can only donate a kidney once.
Shorter waiting time and no dialysis
There are too few donor kidneys from deceased people. That is why there is a waiting list. There are more than 1,000 people on the waiting list for a donor kidney. You often have to wait a long time for a transplant.Read also: On the waiting list for a donor kidney
For a donor kidney from a living donor, the waiting time is usually shorter. Furthermore, the recipient does not have to be (or remain) on the waiting list for a kidney from a deceased donor. By donating a kidney while alive, a kidney becomes available more quickly for someone on the waiting list.
Another advantage is that the transplant can often take place before dialysis is necessary.
Surgery can be planned
It is an advantage that the transplant can be scheduled at a good time for both of you. The kidney does not need to be transported, because the donor and recipient surgeries are in the same transplant center.
The kidney usually works well after the surgery. With a transplant using an organ from a deceased donor, it can take a while before the kidney works properly.
Kidney lasts longer
If you give a kidney to someone else, it is often better. The kidney from a living donor is of good quality. This is monitored during the donor screening. A kidney from a living donor lasts longer on average than a kidney from a deceased donor.
Disadvantages
Donating a kidney is a beautiful and valuable gesture. But there are also disadvantages. Surgery is required for the donation. That always entails risks. You also need time to recover.
Medical examination required
Before you can donate, you undergo extensive medical examinations. These take time. Sometimes something is discovered that you otherwise would not have known. That can be good, but it can also have unpleasant consequences.
Risks of surgery and recovery
Something can go wrong with any surgery, including this one. Usually, these are mild problems that resolve on their own or are easy to treat, but sometimes there are major problems.
After the surgery, you need time to recover. Keep in mind that you will not be able to work for a while and, for example, will need to arrange childcare or household help.
Living with one kidney
You can live perfectly well with one kidney. But if that kidney no longer works well in the future, the consequences are greater than if you still had two kidneys. The advice is to remain under annual check-ups to prevent later kidney problems.
Read more about living with one kidney
Relationship with recipient may change
Is the recipient someone you know? Keep in mind that the donation may change your relationship. Often, it creates a stronger bond, but tensions can also arise—for example, if the other person does not "take good care of your kidney" and, for instance, lives an unhealthy lifestyle.
If your kidney doesn't work as well as expected or you aren't feeling well after the surgery, this can be emotionally difficult for both of you.
“My brother's kidney has changed my life. I am very grateful to him for being willing to do this for me.”
Exciting for the people around you
Donating a kidney while living is nerve-wracking for you, but certainly also for your children or other loved ones.
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 covers medical costs, such as the screening, surgery, and follow-up appointments. You do not pay anything from your excess (deductible) for donation.
Sometimes you have to spend extra money, such as on parking fees or for household help. It is also possible that you may have a temporary reduction in income. You can apply for compensation for this.
Who can help you with your decision?
You do not have to make the decision to donate a kidney alone. It often helps to talk about it with others, for example with:
- A living kidney donation coordinator or medical social worker.
- Your GP.
- Family, friends, or other people in your circle.
- Someone who has donated a kidney themselves (ask the hospital about this).
You can also attend an information evening at a transplant hospital.
Registering
Have you decided to donate a kidney? Then you can register at a transplant hospital.
- Do you want to give a kidney to someone you know? Then contact the transplant hospital (UMC) of your recipient.
- Is it someone you do not know? Then register at a transplant hospital (UMC) in the Netherlands.
- Is it a kidney for a child? Kidney transplants for children are only performed at Amsterdam UMC, Erasmus MC, and Radboudumc.
Questions or registering?
Contact with transplant hospitals in the Netherlands:
- Amsterdam UMC: Email
- Groningen UMCG: Email
- Leiden LUMC: Email or registration form
- Maastricht MUMC+: Email
- Nijmegen Radboudumc: Email or registration form
- Rotterdam Erasmus MC: Email
- Utrecht UMCU: See the information and the registration form on the UMCU website or call 088 75 57 375 (nephrology outpatient clinic - 8:00-17:00)
Good to know: You may change your mind and decide to stop at any time. Even if you have already had examinations. Even just before the surgery.
Decided to donate a kidney?
Read about the examinations you will undergo in the hospital and how the surgery and recovery process work.