Living Kidney Donation
In addition to waiting for a kidney from a deceased organ donor, Northwestern Memorial Hospital patients in need of a kidney transplant may want to consider living donation. Living donation is a transplant surgery performed between two living adults or an adult to child. Although most of us are born with two kidneys, only one working kidney is needed to sustain a normal life. This allows a healthy person the opportunity to donate a kidney to someone with kidney failure.
There are many benefits to receiving a kidney from a living donor, including:
No waiting period, and the surgeries can be scheduled at a convenient time for both the donor and recipient
A kidney from a living donor often works sooner than a kidney from a deceased person, and typically lasts longer
Due to the length of the kidney waiting list, the waiting period for a deceased donor kidney can be many years. Thus, having a living donor can decrease a patient’s waiting time for a kidney transplant, allowing them to avoid dialysis or stop it earlier. This also helps reduce the number of patients on the national waitlist and allows those patients without a living donor option to receive a deceased donor kidney sooner.
Types of Living Donors
Family Member, Spouse, Friend or Acquaintance
A living donor can be a blood-related family member or a non-blood-related individual such as a spouse, friend or acquaintance. Potential donors must be in relatively good health, both physically and emotionally, and over the age of 18.
An increasingly popular form of living donation is called altruistic, non-directed organ donation, in which people donate organs as a humanitarian gesture, without a specific recipient in mind. These organs are distributed to patients on the Northwestern Memorial list using the UNOS priority system or as part of a kidney paired donation.
The goal of Northwestern Memorial’s living donor kidney program is to make every effort to ensure that a transplant takes place when a medically viable living donor steps forward. Approximately one-third of living donors who come forward are not matches for their intended recipient because of blood type or immune system differences. Our transplant team is able to offer various techniques to work around those incompatibilities:
Blood Type & Immune Incompatibility
For a transplant to happen, the donor and recipient must share certain similarities so that the recipient will not reject the donor’s organ. In the past, a blood type incompatibility would have ruled out a donor and recipient pair. Northwestern Memorial is one of only a handful of centers in the country that offers a technique called ABO-incompatible transplantation. A week or two before surgery, and a week or two after the transplant, these kidney recipients undergo a process called plasmapheresis to desensitize and clean out antibodies in the blood. This same process also works for kidney recipients who have multiple antibodies to a donor’s HLA antigens, which are proteins in the blood that help the body’s immune system recognize its own cells and harmful foreign substances. Learn more about the kidney desensitization program.
Kidney Paired Donation
A kidney paired donation (KPD) is a possible solution for donor and recipient pairs who are not compatible with each other. KPD transplants are made possible when a kidney donor who is incompatible with the intended recipient is paired with another donor and recipient in the same situation. Compatible kidney donor and recipient pairs also have the option of participating in a KPD to help out other incompatible pairs. Northwestern Memorial has performed more than 70 KPD surgeries to date, the largest of them being an eight-way paired exchange that involved eight donors and eight recipients. KPD exchanges are becoming more common and signal a trend in the field of organ transplantation. They have the potential to dramatically increase the number of patients who receive transplants, and reduce or eliminate time spent on the waiting list.
After transplant surgery anti-rejection drugs for the organ recipient are necessary, but with prolonged use they can cause serious side effects, including infections, heart disease, cancer and even damage to the kidney. Northwestern Memorial is one of three transplant centers in the country investigating new therapies to help wean transplant recipients off immunosuppression drugs. The protocol of the two studies involves transplanting stem cells from a kidney donor’s bone marrow into the recipient, with the hope of gradually eliminating the need for anti-rejection drugs. If research proves successful, it would mean a dramatic change in recipients’ post-transplant quality of life.
About the Surgery
When a living person donates a kidney, the donor and recipient surgeries are done on the same day. The operation performed to remove the healthy kidney from the donor is called a nephrectomy. This is a major surgery and there are some risks involved. At Northwestern, all of these surgeries are done using a laparoscopic, or minimally invasive, approach. Patients undergoing laparoscopic kidney removal have significantly less pain, a shorter hospital stay and return to normal life much faster than those who undergo the more traditional “open” procedure.
Why Northwestern Memorial
Northwestern Memorial has the largest living donor kidney transplant programs in the country, performing 154 living donor kidney transplants in 2011. Not all transplant centers have the expertise to perform laparoscopic donor surgery. Northwestern Memorial is fortunate to have four specially trained transplant surgeons who have successfully performed more than 1,800 laparoscopic donor surgeries since 1997 utilizing video technology to allow the kidney to be removed safely through small incisions on the abdomen.
In addition to the downtown campus, we are available to see patients at any one of four Northwestern Medical Faculty Foundation transplant outreach clinics, in Oak Brook, Glenview and Joliet, Illinois, and Portage, Indiana. Our focus on community outreach benefits patients and their physicians by providing pre-kidney transplant services closer to home. Learn more . . .
If you have a questions about living kidney donation, please call 312-695-0828
The Kovler Organ Transplantation Center
Arkes Family Pavilion
676 N. St. Clair, Suite 1900
Chicago, Illinois 60611