Kidney donation

Kidney transplants have a high success rate. People who need a transplant may have any of a number of conditions that lead to kidney failure, meaning their own kidneys can no longer adequately remove waste and excess fluid from the blood.

People can survive kidney failure with dialysis, but a transplant, where suitable, can offer a longer and more active life and reduces the need for strict dietary and fluid restrictions.

Kidneys are often donated after death#

Unfortunately, there are more people waiting for a kidney than there are available donors. Not everyone is medically suitable to receive a donated kidney, and some people may choose not to have a transplant. For these patients, dialysis is the main treatment option.

By choosing to donate after death, you can give someone the potential for a longer and more active life than they would have on dialysis. A transplant from a deceased donor can be used for medically suitable people who have been stabilised on dialysis.

A person must be declared dead before their organs and tissues can be used. Two legal definitions of death are commonly recognised:

• circulatory death, when a person’s heart permanently stops functioning
• brain death, when a person’s brain permanently stops functioning

The type of death, the health of the organs, and the condition of the potential donor’s tissues all influence how the donation process occurs and which organs and tissues can be donated.

Living donation#

For some tissues and organs, a living donation is possible because the tissue or cells can regenerate, so the donor has no lasting loss of function after a successful donation. Kidneys cannot regenerate, but because we have two, healthy people can donate one and continue to function well with the remaining kidney.

To be a living kidney donor, you must be in good physical and mental health. You would typically be a healthy adult with a relatively low risk of developing significant kidney disease during your lifetime. A specialist medical team carries out tests to make sure your blood and tissue types are a suitable match.

A close match is more likely with genetically related donors. A donation directed to a specific relative or friend is called a directed donation. Most living kidney donors are biological relatives, such as a parent, brother or sister, where a close blood and tissue match reduces the risk of the organ being rejected.

Biologically unrelated people, such as partners or close friends, can also donate if they are compatible. In a non-directed donation, someone altruistically donates a kidney to be given to the next suitable person on the waiting list. The privacy of the donor and the identity of the recipient are protected.

Paired kidney exchange is another form of living donation that helps increase the number of donors and recipients. Sometimes a person who is eligible for a transplant has a relative or friend who wants to donate, but they have an incompatible blood or tissue type. In these cases, a database of donor and recipient pairs can be searched to find combinations where the donor in one incompatible pair is matched to a recipient in another. In this way, two or more living kidney donations can take place at the same time.

A donated kidney from a living person is likely to remain healthy for longer than one from a deceased donor.

However, there is some risk to the donor#

The surgery lasts about three hours and is usually followed by a hospital stay of four or five days. As with any operation it can have complications, but people can generally resume their everyday lives after six to eight weeks. Donating a kidney is not likely to cause long-term health problems, unless the remaining kidney later becomes injured or diseased.

Key points#

• People can survive kidney failure with dialysis, but a transplant can offer a longer and more active life.
• For people who are not suitable for or do not want a transplant, dialysis is the main treatment option.
• Living donation is possible for some tissues and organs because the cells can regenerate; kidneys cannot regenerate, but a healthy person can function well with one kidney.
• A donated kidney from a living person is likely to remain healthy for longer than one from a deceased donor.
• There is some risk to the donor, though long-term health problems are unlikely.

Where to get help#