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This is an educational document is designed to provide you with information to consider in deciding whether to participate as
a living kidney donor. The document describes:
All potential kidney donors must demonstrate that the decision to donate is made freely, electively and without coercion or valuable compensation.
Living donors will receive a thorough medical and psychosocial evaluation. You will take a variety of tests to ensure that you are an eligible candidate for living donation. In addition, before the surgery, you will meet with doctors and other members of the donation team. The tests and consults will help the donation team decide if you are well enough to be a living donor and if you match a recipient. Parents, siblings, and other relatives can donate to a family member.
Transplant Team Members
The Program Director leads and oversees the transplant program.
The transplant surgeon meets with you to discuss the organ transplant process, including the transplant surgery itself, the risks of the surgery, and any problems you might have after your transplant.
The transplant doctor meets with you to discuss the organ transplant process.
The transplant coordinator provides support throughout the transplant process and works with you to make sure your needs are met. The transplant coordinator will explain the entire transplant process and will answer your questions so that you can learn as much as possible about your transplant.
The social worker meets with you to see how well you can cope with the stress of a transplant, and how well you will be able to follow a demanding treatment plan. The social worker will also help you identify family and friends who can help you during this time. Alternative financial resources (e.g. fundraising, assistance programs) can be explored if needed.
The financial counsellor discusses the costs of the organ transplant, medications and care. The financial counsellor also helps you understand your insurance coverage. It is important that you are aware of and understand any costs that may not be covered by your insurance.
The psychiatrist performs a more thorough psychiatric examination to make sure you are prepared for a transplant. Some patients who have abused drugs or alcohol may have to go through a rehabilitation program and stay away from drugs and alcohol for a period of time in order to start the transplant program.
Assesses your diet to learn what you eat on a daily basis and teaches you about eating a healthy diet.
The pharmacist reviews your medications and assesses for potential drug interactions before and after transplant. The pharmacist can also review education regarding the transplant medications
Please note that you may see other specialists, depending on your overall health.
Tests and Procedures
You will undergo a variety of tests to understand your eligibility to be a donor. The following is a list of the most commonly
performed tests. Some of these tests may be included in your evaluation process, whereas other tests may need to be
performed depending on the results of these tests.
Blood tests will determine your blood type for kidney donation, your health status, your match to the recipient and will screen
for immunity or the presence of specific viruses (including HIV/AIDS).
Urine tests screen for urinary tract infections, protein, blood and other abnormalities. They may also test for drugs and alcohol in your system.
During the kidney donor operation, you will be put under general anesthesia, which means that you will be given medications to put you to sleep, block pain and paralyze your body. You will also be placed on a machine to help you breath. The anesthesiologist will discuss with you in more detail about the anesthesia prior to your surgery.
Once you are asleep, a breathing tube, intravenous lines and a urinary catheter will be placed in your body. To keep you from vomiting, you may have a tube placed through your nose into your stomach to drain the contents of your stomach.
The kidney donation surgery involves removing a healthy kidney from your body and placing it into a recipient's body where it can perform all the functions that a failing kidney cannot. Your kidney will be removed using one of two methods: laparoscopic nephrectomy or open nephrectomy.
This is a minimally invasive procedure in which a special camera called a laparoscope is used to produce an inside view of
the abdominal cavity to remove a kidney. Laparoscopic kidney removal is considered minimally invasive because it minimizes
abdominal incisions required to remove the kidney.
This can be done using three to four small skin incisions to perform the surgery, and then remove the kidney from a low
incision in the pelvis or through a new approach by placing one incision in the navel area. During the procedure, carbon
dioxide gas is passed through one of the incisions into the abdominal cavity to lift the abdominal wall away from the organs
below, creating more operating spaces to perform the surgery. The surgeon will use laparoscopic instruments to separate the
kidney. Once your kidney is separated, your surgeon will remove it through a non-muscle cutting incision in the lower abdomen
area or the navel area (six to seven centimeters).
One approach to laparoscopic donor nephrectomy is where the surgeon uses the small incision needed to remove the kidney
during the surgical procedure. Generally, a seven centimeter incision is made over the navel in addition to two small incisions
for laparoscopic operative ports.
A laparoscopic camera and laparoscopic instruments are placed into the ports. Each of these incisions avoid dividing any
muscle. Laparoscopic instruments are used to remove the kidney after the abdomen is inflated with carbon dioxide gas. Once
the kidney is divided, it can rapidly be removed through the navel port, so the recipient surgical team can begin preparation for
Care and Recovery
After your surgery, you will be taken to a specialized Post-Anesthesia Care Unit (PACU) until you have recovered from the anesthesia and there are no signs of immediate or early complications.
After your stay in the PACU, you will be transferred to the surgical inpatient unit where you will be closely monitored until
you are discharged. Immediately after the surgery, some pain, gas and discomfort is normal. The nursing team will carefully
monitor this and administer medication to control the pain. Most kidney donors see a sharp decrease in pain two to three days
after surgery. Getting out of bed and starting to walk will greatly help.
You may need to remain in the hospital longer than expected depending on how quickly you recover, or as determined by your doctor.
After you leave the hospital, you will still be recovering. For the first few weeks, you will have some limits on your daily activities. If you have any complications after the surgery, your recovery time may be longer. During the recovery period,the kidney donor team will follow your progress very closely including a post-surgical clinic visit, usually 2-6 weeks after the kidney donation. If you have any signs of infection or any other complication from kidney donation, you may have to bereadmitted to the hospital or return for additional clinic visits.
Long-Term Follow Up After Donation
You will require long-term follow-up after the kidney donation procedure. It is requested that all living donors commit to having the post-donation follow-up coordinated by the living donor team. If you are unable to return to CCAD for this follow-up, arrangements can be made with your Primary Care Provider (PCP) to ensure that CCAD receives the necessary information.
Follow-up care will consist of clinic visits, blood work, urine samples and vital signs. Your name and clinical information will also be placed in a CCAD database registry for tracking and follow-up purposes.
Any infections disease or malignancy pertinent to acute recipient care discovered during the donor's first two years of postoperative follow-up care will be disclosed to the donor and will be disclosed to the recipient's transplant team at CCAD.
Post Donation Kidney Function
Benefits Associated with Living Donation
Kidney transplant surgery can be scheduled at a mutually agreed upon time rather than performed as an immediate operation.
A potential psychological benefit for the recipient is that the recipient may experience a positive feeling knowing that the gift came from a loved one, friend or a caring stranger. In addition, the donor may experience the satisfaction of knowing that he or she has contributed to the improved health of the recipient.
There are risks with all surgeries, especially surgeries that are done under general anesthesia. Many complications are minor and improve on their own. However, in some cases, the complications are serious enough that you might need another surgery or medical procedure. Some patients may require readmission to the hospital for medical care.
The following medical, surgical, psychosocial and financial risks are associated with living kidney donation. These risks may betransient (e.g. temporary or occasional) or permanent and include, but are not limited to the following:
Medical or Surgical Risks
Health and Life Insurance
After organ donation, health insurance companies might consider that you have a pre-existing condition, and might refuse payment for medical care, treatments or procedures. After the surgery, your health insurance and life insurance premiums may increase and remain higher. In the future, insurance companies might refuse to insure you.
Right to Opt-Out of the Donation Process
You do not have to participate as a living kidney donor.
If you decide to participate, you may change your mind at any time, including the day of your scheduled surgery. If you change your mind, simply notify any member of the Living Kidney Donor Team or Kidney Transplant Team. If you change your mind about participating, your decision and reasons are kept confidential.
Communication between the donor and the Transplant Center's Living Donor office will remain confidential. Only information crucial to assuring the safe donation/transplantation of the organ will be shared with the corresponding teams.
Please note: You will be asked to sign a consent form acknowledging that you have received this document and stating that you agree to proceed with the evaluation process at your first appointment.
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This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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