Getting the word out about living kidney donation is a constant process. If you are an advocate for living donation, keep spreading the word, it will be the first time for many people to hear about this. 

Relatives, loved ones, friends and even individuals who wish to remain anonymous often serve as living donors to spare a patient a long and uncertain wait. In 2020, more than 5,700 transplants were made possible by living donors.

Kidney and liver transplant candidates who can receive a living donor transplant can receive the best quality organ much sooner, often in less than a year.

Facts about Living Donation

  • Living donation is an opportunity to save a life while you are still alive.
  • Living organ donation and transplantation were developed as a direct result of the critical shortage of deceased donors. 
  • Living donors don’t have to be related to their recipients. On average, 1 in 4 living donors is not biologically related to the recipient.
  • Patients who receive a living donor transplant are removed from the national transplant waiting list, making the gift of a deceased donor kidney or liver available for someone else in need.

If you are considering being a living donor, it’s important to note that living donation is not included in your deceased donor registration.

Who can be a living donor?

Living donors should be:

  • in good overall physical and mental health and
  • older than 18 years of age.

Medical conditions such as uncontrolled high blood pressure, diabetes, cancer, certain infections, or an uncontrolled psychiatric condition, could prevent you from being a living donor.

What are the types of living donor transplants?

The kidney is the most commonly transplanted organ from a living donor.

Directed donation

In a directed donation, the donor names the specific person to receive the transplant. This is the most common type of living donation. The donor may be:

  • a biological relative, such as a parent, brother, sister, or adult child,
  • a biologically unrelated person who has a personal or social connection with the transplant candidate, such as a spouse or significant other, a friend or a coworker, or
  • a biologically unrelated person who has heard about the transplant candidate’s need.

If tests reveal that the donor would not be a good medical match, a paired donation may be an option.

Paired Donation

Sometimes a transplant candidate has someone who wants to donate a kidney to them, but tests reveal that the kidney would not be a good medical match. Kidney paired donation, or KPD, also called kidney exchange, gives that transplant candidate another option. In KPD, living donor kidneys are swapped so each recipient receives a compatible transplant.

This type of exchange often involves multiple living kidney donor/transplant candidate pairs.

Non-direct Donation

In non-directed donation, the donor does not name the specific person to get the transplant. The match is arranged based on medical compatibility with a patient in need. Some non-directed donors choose never to meet their recipient. And some candidates choose not to meet their donor. And in other cases, the donor and recipient may meet at some time, if they both agree, and if the transplant center policy permits it.

Other donation types: blood type incompatible and positive crossmatch

Blood type incompatible donation occurs when a transplant candidate receives a kidney from a living donor with a non-matching blood type. To decrease the risk of rejection of the donated organ, the candidate receives specialized medical treatment before and after the transplant. This may include removing the transplant candidate’s spleen during the transplant.

Positive crossmatch donation involves a living donor and a transplant candidate who do not match because the candidate has certain antibodies (a protein substance) that will immediately react against the donor’s cells and cause the transplant to fail. Specialized medical treatment (plasmapheresis) is provided to prevent rejection. This type of donation is usually only considered when no other living donors match.

How do I become a living donor?

Getting started

1. Contact a transplant center

If you know a person you would like to help through living-directed donation, talk to him or her and contact the transplant program where the person is listed. If you would like to be a living non-directed donor, contact a transplant center of your choice to find out if they have this type of donation program. 

When you contact transplant center staff, they will typically ask for your consent to begin a basic medical screening. With your consent, the transplant center staff will ask you questions about your medical history to find out if you have any conditions that would keep you from being a donor.

2. Have an initial screening

This initial screening is typically followed by a blood test to see if you are compatible with the intended transplant candidate. If you are not compatible with that person, you may have other options to donate. These options include paired exchange, blood type incompatible donation or positive crossmatch donation.

3. Get an independent donor advocate

Transplant centers are required to provide an independent donor advocate (IDA) or IDA team for all potential donors. Your IDA should not be part of the potential transplant recipient’s medical team. The IDA will assist you during the donation process.

Reviewing national and transplant center data may affect your decision to become a donor; however, there are limited long-term data available on how living donors do over time.

Talk with your transplant center about their living donor follow-up procedures and ask about data they have collected. They are often able to provide you useful information such as:

  • the number of living donor surgeries performed at the center,
  • the percentage of living donors who receive two years of required follow-up,
  • the number of living donors who have had medical problems, including any incidents, reported to the UNOS patient safety system,
  • transplant recipient and transplanted organ survival rates and
  • any Medicare outcome requirements that the center has not met (such as meeting expectations relating to the number of transplants done and recipient and organ survival rates).

More Information

For more information on how to start the process of becoming a living donor, contact a living donor transplant program in your area. You can find contact information for living donor transplant programs and other helpful patient information at UNOS

Learn more about Kidney Transplant.

* We have extracted this information from UNOS where Dr. Denise Alveranga is the Minority Transplant Professional Representative Denise Alveranga, M.D., FACP, FASN 

For more information, please visit the UNOS website.