| Living Donors
Facts About Living Donation
The first successful living donor transplant was performed between 23-year-old identical twins in 1954. Doctor Joseph E. Murray at Peter Bent Brigham Hospital in Boston, MA, transplanted a healthy kidney from Ronald Herrick into his twin brother, Richard, who had chronic kidney failure. Richard Herrick went on to live an active, normal life, dying eight years later from causes unrelated to the transplant.
Since that time, thousands of patients have received successful transplants from living donors, which are handled by the center or hospital doing the transplant. For more information, contact your local organ procurement organization (OPO) or transplant program.
Living donor transplants are a viable alternative for patients in need of new organs. Many different types of organs can be delivered by living donors, including:
This is the most frequent type of living organ donation. For the donor, there is little risk in living with one kidney because the remaining kidney compensates to do the work of both kidneys.
Individuals can donate segments of the liver, which has the ability to regenerate the segment that was donated and regain full function.
Although lung lobes do not regenerate, individuals can donate a lobe of one lung.
Individuals can also donate a portion of the pancreas. Like the lung, the pancreas does not regenerate, but donors usually have no problems with reduced function.
Although very rare, it is possible to donate a portion of your intestine.
A domino transplant makes some heart-lung recipients living heart donors. When a patient receives a heart-lung “bloc” from a deceased donor, his or her healthy heart may be given to an individual waiting for a heart transplant. This procedure is used when physicians determine that the deceased donor lungs will function best if they are used in conjunction with the deceased donor heart.
Qualifications for Living Donors
In order to qualify as a living donor, an individual must be physically fit, in good general health, and free from high blood pressure, diabetes, cancer, kidney disease, and heart disease. Individuals considered for living donation are usually between 18-60 years of age. Gender and race are not factors in determining a successful match.
The living donor must first undergo a blood test to determine blood type compatibility with the recipient.
Blood Type Compatibility Chart
Recipient's Blood Type Donor's Blood Type
||Love Give Life
||A or O
||B or O
||A,B, AB or O
If the donor and recipient have compatible blood types, the donor undergoes a medical history review and a complete physical examination. The following tests may be performed:
Tissue Typing: the donor’s blood is drawn for tissue typing of the white blood cells.
Crossmatching: a blood test is done before the transplant to see if the potential recipient will react to the donor organ. If the crossmatch is “positive,” then the donor and patient are incompatible. If the crossmatch is “negative,” then the transplant may proceed. Crossmatching is routinely performed for kidney and pancreas transplants.
Antibody Screen: an antibody is a protein substance made by the body’s immune system in response to an antigen (a foreign substance; for example, a transplanted organ, blood transfusion, virus, or pregnancy). Because the antibodies attack the transplanted organ, the antibody screen tests for panel reactive antibody (PRA). The white blood cells of the donor and the serum of the recipient are mixed to see if there are antibodies in the recipient that react with the antigens of the donor.
Urine Tests: In the case of a kidney donation, urine samples are collected for 24 hours to assess the donor’s kidney function.
X-rays: A chest X-ray and an electrocardiogram (EKG) are performed to screen the donor for heart and lung disease.
Arteriogram: This final set of tests involves injecting a liquid that is visible under X-ray into the blood vessels to view the organ to be donated. This procedure is usually done on an outpatient basis, but in some cases it may require an overnight hospital stay.
Psychiatric and/or psychological evaluation: The donor and the recipient may undergo a psychiatric and/or psychological evaluation.
The decision to become a living donor is a voluntary one, and the donor may change his or her mind at any time during the process. The donor’s decision and reasons are kept confidential.
Copyright © 2003 United Network for Organ Sharing. www.unos.org. All rights reserved.
Living donation offer many advantages over cadaveric donation:
- The kidney, when obtained from a living donor, is usually a better match, which reduces the risk of rejection (more than a 90 percent success rate for the first year)
- Kidneys from living donors last longer than cadaveric organs
- The patient does not have to wait months or years for an organ
- The transplant can be scheduled when both patient and donor are ready
- Patients do not have to take as much anti-rejection medication
- Living donated kidneys begin to function immediately; cadaveric donors may take several days or weeks to begin working
Q and A for Living Donors
Children's Organ Transplant Association
Transplant Recipients International Organization ( TRIO)
National Living Donor Assistance Center