Are you considering donating a kidney? On this page, you will find more information about how kidney donation works. Here you can find information about the preparation for a kidney donation, more details about the operation itself and the consequences of the operation for you.
Step 1: Information about living kidney donation
If you are thinking about giving a kidney to someone you know or an unknown person, you can contact the Erasmus MC. First of all, you will visit the nephrologist for an information session. You can come by yourself, or with your recipient. You will receive information about kidney donation and kidney transplantation. You will also be given information materials to take home. We can make a follow-up appointment if you would like. You will then have time for all the information to sink in and to think more about the donation. If you are sure about your wish to donate, we will continue to step 2.
Step 2: Preparation for donation
If you would like to donate a kidney, there will first be some initial examinations. We will look at whether you are healthy enough to donate. The examinations will start immediately and will be finished within around three months. You can only donate if there are no concerns about you living with one kidney and if you can withstand the operation. The examinations will be carried out by the nephrologist and the kidney transplant nurse practitioner.
Determining blood group
First of all, we will determine your blood group. This will show us whether you can donate directly to your recipient. In order to donate directly, the blood group must be a match (see matching blood groups). If there is no match, you can participate in one of the alternative donation programmes.
Cross-matching and tissue typing
If your blood groups are a match, a crossmatch and tissue typing will be carried out. Here we will check that your kidney will not be rejected by the recipient. If your cross-match is positive which means the change are high that the kidney will be rejected, you can participate in one of the alternative donation programmes.
There will also be examinations to determine whether you are healthy. This involves the following examinations: an ECG, a chest x-ray, a blood and urine test, a CT scan and a physical examination. Additional examinations are sometimes also necessary. You will also have an intake interview with the kidney transplant coordinator, as well as an interview with a medical social worker.
Read more under ‘Donation options’.
Waiting for the operation
Once you have successfully completed the preparation process, the nephrologist, transplant surgeon and anaesthetist will determine whether you can withstand the operation. When they have given you the green light, you and your recipient will be added to the waiting list for an operation. The waiting list for the operation varies from 1 to 4 months.
Step 3: The surgery
You will be admitted one day before the surgery. In a transplant, you will undergo the operation first. In case of a direct donation, you will be able to see your recipient again before the surgery. At the Erasmus MC, the recipients and donors are not cared for in the same room. This is done because you will both need to rest after the operation. Experience has also shown that for the recipient the fact that donor is not feeling well after the operation can be a negative experience, and vice versa. Your recipient will be brought to the operating theatre during the morning or early afternoon.
The operation is usually carried out using laparoscopic surgery, possibly using hand-assisted or robot assistance. The surgeon will discuss this with you in advance. You will lie on your side on the operating table. Your kidney will be disconnected using instruments. Finally, the kidney will be removed through an incision above the pubic bone. This will leave you with 3 or 4 small scars of about 1 cm on your stomach and a 7 to 10 cm scar above your pubic bone
After the surgery, you will stay at the hospital for 3 to 5 days. As with any surgery, there are risks associated with a kidney donation. Fortunately, the risk of complications is low for this intervention. There is a risk of bleeding or a wound infection, for example. It is therefore important for you to mention new or worsening complaints. For 90% of donors, a recovery period of 6 weeks is sufficient, before returning to work, for example.
Step 4: After donation
One week after the operation, the transplant surgery nurse practitioner will phone you. Two to three weeks after the operation, you will come to the outpatient polyclinic for a check-up with the transplant surgery nurse practitioner or transplant surgeon. During this check-up, we will check the progress of your recovery. The transplant surgery nurse practitioner or transplant surgeon will also check that your wounds are healing properly and will check your renal function through your blood. If the surgeon is satisfied, you will not need to come back for any more surgical check-ups.
After three months, you will come to the Nephrology polyclinic to see the transplant surgery nurse practitioner. During this consultation, your blood pressure will be measured and your weight recorded. Your renal function will be checked through your blood and urine. You will also have an evaluation interview with the kidney transplant coordinator.
From this point you will have an annual check-up with the kidney transplant nurse practitioner.