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 in the production of red blood cells.
- Ensuring strong bones through a proper 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?
When the kidneys no longer work properly, they can no longer perform these tasks well, and waste products remain in your body. This can lead to kidney failure: the kidneys barely function at all. Dialysis or a kidney transplant is then often necessary.
What is dialysis?
During dialysis, a machine takes over the function of the kidneys. The blood is cleaned artificially. Patients often undergo dialysis several times a week. This takes a lot of time and works much less well than real kidneys. Dialysis also does not take over all the functions of the kidneys. As a result, many people feel tired or sick. Working or going to school can be difficult. Eventually, dialysis stops working well enough.
When is a kidney transplant needed?
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 feel better quickly than before the operation. They have more energy. Still, a kidney transplant is not possible for everyone. For example, you might be too sick for the surgery. It can also take a long time before there is a donor kidney that is a good match for the patient.
Also read: 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 also undergo examinations to see if you are physically healthy enough and if you can mentally handle the donation well.
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 general practitioner.
- You have decided voluntarily to give a kidney. No one has pressured you and you receive no 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 have no risk factors or (hereditary) disease that might cause your kidneys to function less well later. The kidney you keep yourself must continue to function 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 donate a kidney. The hospital will then examine whether you are fit enough for the surgery, and whether your kidney is suitable for the recipient.
Does your kidney match the recipient?
To see if a donation is possible, tests are needed. The doctors check whether the blood types match, whether the recipient produces antibodies, and whether the tissues match. Read more about it below.
Do the blood types match?
Your blood type and the recipient's must be compatible. That doesn't 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 here.
Sometimes direct transplantation is still possible even if the blood types of the donor and the recipient do not match. In that case, the recipient receives extra medication prior to 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. For this, a vial of blood is drawn from you and the recipient. In the laboratory, they investigate whether the recipient has antibodies against your kidney. In the event of a strong immune response (positive crossmatch), the chance of kidney rejection is very high. In that case, direct donation is usually not possible.
Sometimes transplantation can still proceed after a special treatment. This is called desensitization. The recipient is then given medications 1 to 2 weeks before the transplantation that remove 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 medications can cause side effects. Therefore, it is always first examined whether you can participate in the cross-over program.
Do the tissues match?
Another test is tissue typing (HLA typing). This involves a blood test to see how well the donor's tissue matches that of the recipient.
Who can you donate a kidney to?
You can donate a kidney during your lifetime 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. Therefore, it is good to talk about this before the donation. Clearly communicate your expectations to one another. Do you expect, for example, that the recipient will start living a healthier life or enjoy life more?
Sometimes there are multiple people willing to give a kidney to the same recipient. The hospital then takes multiple 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 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 contacts the donor themselves before contacting the transplant hospital.
Do more people respond to the call? Then the hospital, in consultation with the recipient and donors, determines who will be investigated further first.
Exchanging with another couple: cross-over
Do you want to give a kidney to someone you know, but is it 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 wonderful gesture. But a lot will also come at you. Review the pros and cons to make a good 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 to whom you give your kidney. You can only give up 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.Also read: On the waiting list for a donor kidney
For a donor kidney from a living donor, the waiting list is usually shorter. Moreover, the recipient does not have to be on the waiting list (anymore) for a kidney from a deceased donor. By donating a kidney during life, a kidney becomes available sooner for someone on the waiting list.
Another advantage is that the transplantation can often take place before dialysis is necessary.
Surgery can be planned
It is an advantage that the transplantation can be planned at a good time for both of you. The kidney does not need to be transported, because the operations of the donor and recipient take place in the same transplantation center.
The kidney usually works well after the operation. With a transplantation using an organ from a deceased donor, it can take a while before the kidney functions 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 checked during the screening of the donor. A kidney from a living donor generally lasts longer than a kidney from a deceased donor.
Disadvantages
Donating a kidney is a fine and valuable gesture. But there are also disadvantages. An operation is required for the donation. That always entails risks. You also need time to recover.
Medical examination required
Before you can donate, you will undergo extensive medical examinations. Those take time. Sometimes something is discovered that you wouldn't have known otherwise. That can be nice, but it can also have unpleasant consequences.
Risks of surgery and recovery
Something can go wrong with any operation, including this one. Usually these are mild problems that resolve on their own or are easily treatable, but sometimes there are major problems.
After the operation you will 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 just fine with one kidney. But if that kidney does not work properly 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 can change your relationship. Often you develop a stronger bond. But tensions can also arise. For example, if the other person does not 'take good care of your kidney' and, say, lives unhealthily.
If your kidney doesn't work quite as well after all, or if you feel less well yourself after the surgery, this can be emotionally difficult for both of you.
“My brother's kidney changed my life. I am very grateful to him for wanting to do this for me. ”
Exciting for the people around you
Donating a kidney during life is exciting for yourself, 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 ultimately does not go ahead.
Your health insurance covers medical costs, such as screening, surgery, and check-ups. You pay nothing 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 temporarily have less income. You can apply for compensation for this.
Who can help you with your decision?
You do not have to make the choice 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 general practitioner.
- Family, friends, or other people in your social circle.
- Someone who has donated a kidney themselves (ask the hospital about this).
You can also attend an information evening at a transplant hospital.
Register
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 don't know? Then register at a transplant hospital (UMC) in the Netherlands.
- Is it a kidney for a child? Kidney transplantations in children are only performed at Amsterdam UMC, Erasmus MC, and Radboudumc.
Questions or to register?
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 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 tests. Even just before the surgery.
Decided to donate a kidney?
Read about what tests you will undergo in the hospital and how the surgery and recovery proceed.