Guest guest Posted September 21, 2004 Report Share Posted September 21, 2004 Division of Transplantation... Request An Appointment Program for: Kidney... Laparoscopic Kidney Removal High PRA Rescue Indications and Contraindications Q A for Kidney Donors Kidney Donation Video Transplant Team Statistics Online Resources Kidney/Pancreas... Liver... Heart Lung Pediatric Transplant... Information For: Patients... Physicians... Patient Testimonials Transplant News: News Releases In the News Contact Us Transplant Center Laparoscopic Live Donor Nephrectomy Provides Less Invasive Alternative View Video Learn more about living kidney donation by watching this video, which includes information about the procedure from University of land Medical Center transplant surgeons and staff, and patient stories. View Video. How do family members know when it is time to consider donation? Do some donors have trouble making the decision to donate a kidney? Who can be a donor? What's the first step in the donation process? What does the rest of the evaluation include? What are your health risks? Will giving a kidney affect your lifestyle? Do donors have any trouble keeping or getting insurance after the operation? Will giving a kidney affect your ability to become pregnant or to father a child? If I decide to be a donor, how do I prepare? What happens during surgery? What happens after surgery? What should I expect during my recovery at home? What emotions do donors say they feel after the surgery? Who pays for your medical costs? Are there any expenses not paid by private insurance or Medicare? Donating a kidney is a major decision. There are many things you should know before making your decision. This web site will answer some of those questions. In addition, we have many health care professionals who can also help you make your decision. It is important that you fully understand how donating a kidney will affect you and your family. Currently, kidneys from a living donor have a better long-term survival than kidneys from a cadaver donor. Also, cadaveric kidney donation cannot meet the needs of all patients in this country who need a kidney transplant. The waiting time for a cadaveric donation may be two to four years. Kidney donations from living relatives have always been a better option. More recently, kidneys donated from unrelated living donors (such as a spouse or a friend) have been as successful as those from close relatives. The Transplant Program at the University of land Medical Center is one of the few centers that provides a less invasive surgery for kidney donors. Laparoscopic surgery can make donating a kidney to a loved one easier. Using the laparoscope, surgeons make only a small incision above the navel -- about two-and-a-half inches -- as well as four small holes through which they insert instruments. The laparoscope contains a miniature camera, and surgeons watch what they are doing on a video monitor. The traditional " open " surgery requires an incision about ten inches long that cuts through abdominal muscles. Laparoscopic surgery can mean less pain, no sutures or staples, a shorter hospital stay and a much faster recovery for the donor. Since March 1996, surgeons at the Medical Center have performed more than 300 laparoscopic procedures for kidney donation. In all of the cases, the transplanted kidneys were functioning well after surgery. Our transplant team will be happy to arrange for you to meet with people who have donated a kidney. You can reach the transplant coordinators at How do family members know when it is time to consider donation? When a patient loses 90 to 95 percent of his or her kidney function, life-saving treatment becomes necessary. This treatment can be either dialysis (removal of wastes from the blood by an artificial kidney machine) or a kidney transplant. We sometimes perform kidney transplants on patients with 10 to 15 percent remaining kidney function. This avoids the need for dialysis and the surgery that a patient needs in order to undergo dialysis. Patients and family members should discuss the benefits and disadvantages of each treatment with their doctors. Back to Top Do some donors have trouble making the decision to donate a kidney? Some people make the decision instantly with few worries or concerns. Others go through some soul-searching before deciding. It is quite normal to be afraid of giving a kidney and to experience guilt about not wanting to be a donor. Remember: the only " right " decision is the one that makes you, the potential donor, feel comfortable. Back to Top Who can be a donor? In addition to parents, children and siblings, living donors can also include distant relatives, adoptive relatives, in-laws, friends, church members, co-workers, etc. The donor and the kidney recipient need to have compatible blood types, and the donor must be willing and healthy. It is very important that potential donors understand exactly what the procedure involves, including testing, surgery, recovery period and possible risks. A psychological evaluation of a potential donor may also be conducted. In order to be a potential donor, you must be in good general health. You must not suffer from high blood pressure, cancer, diabetes, kidney disease or heart disease. Donors can be between 18 and approximately 60 years of age. Back to Top What's the first step in the donation process? If you decide to be considered as a donor, two blood tests determine if your blood type is compatible with the transplant candidate and the degree of HLA matching. If your blood type is not compatible, you cannot donate. (More information about HLA type match follows in this brochure.) If your blood type is compatible, the transplant staff will discuss the donation process with you. They will give you the information you need to make an informed decision. All discussions are kept strictly confidential. Also, your individual circumstances are evaluated. For example, can you take the time off from work that is needed for surgery and recovery at home? If you decide to become a donor, the rest of the evaluation begins. Back to Top What does the rest of the evaluation include? The HLA tissue typing test, performed as part of the first step, shows how well you match with the recipient. Your blood cells are then mixed with the serum of the recipient in a " crossmatch " test to see if that serum " kills off " your cells. If cells are killed, it means that the immune system of the recipient would reject your kidney. Crossmatch tests are repeated a week before surgery because the crossmatch can change. Even if the crossmatch is not favorable for a transplant now, it may be favorable in the future. Once the tissue typing and crossmatch are determined, you will see a doctor of your choice or a transplant nephrologist at the Medical Center. The doctor will do a medical history and a physical, as well as check your blood pressure to ensure that you do not have any health conditions that would rule you out as a donor. A series of laboratory and X-ray tests are conducted to screen for kidney function, liver function, hepatitis and other viruses or infections. A urine collection shows if your kidneys are functioning normally. A chest X-ray and an electrocardiogram make sure your heart and lungs are normal. Other tests may be necessary depending on the results of these studies. If the doctor agrees you are a good candidate, the final studies, a computerized tomography (CT) scan and an intravenous pyelography (IVP), will be done at the same time. In these tests, dye is injected into the bloodstream through a vein in your arm. The dye travels to the kidneys and the urinary tract while CT scans and X-rays are done. These tests help the transplant staff find out if your urinary tract, kidneys and the blood vessels leading to them are normal. These procedures are performed in the hospital on an outpatient basis and usually take one hour. You can drive home afterwards. Tests will be arranged by the transplant office. Testing may occur at the University of land Medical Center or locally by a private doctor. Tests by private doctors are completed under the direction of protocols facilitated by the Medical Center's transplant coordinator. Back to Top What are your health risks? Death from kidney donation is extremely rare (about 3 in 10,000). Donating a kidney does not change your life expectancy nor does it increase your chance of kidney failure. The health effects of kidney donation have been and continue to be carefully studied by several research groups in the United States. This research has shown that kidney donation does not appear to put donors at any increased risk for future health problems. Back to Top Will giving a kidney affect your lifestyle? A person can lead an active, normal life with only one kidney. Studies have shown that one good kidney is enough to keep the body healthy. After recovery from surgery, you can work, drive, exercise and participate in sports as usual. You can continue in all types of occupations, including military duty. Back to Top Do donors have any trouble keeping or getting insurance after the operation? A national study of 536 donors showed that donors have very few problems getting insurance after the surgery. In the study, only four percent had difficulty obtaining health insurance, four percent had problems getting life insurance, and two percent had difficulty getting disability insurance. In rare cases, a routine physical examination and a waiting period of from one to three years was needed to satisfy the insurance companies. Back to Top Will giving a kidney affect your ability to become pregnant or to father a child? There is no evidence that donating a kidney has any effect on the ability of donors to have children. Among donors studied, 87 percent made no attempt to have children, while 12 percent tried and were successful. Back to Top If I decide to be a donor, how do I prepare? You will receive counseling to help prepare you for the emotional aspects related to donation. You will also be given specific instructions on how to prepare for your surgery and recovery. Back to Top What happens during surgery? Once the surgery date has been set, another crossmatch test is given one week before surgery. The day before surgery both you and the recipient come to the hospital for pre-admission testing. You will not actually be admitted to the hospital until the morning of the surgery. If you live far from the hospital, local free hotel arrangements can be made through the transplant office. On the night before surgery, you may not eat or drink anything after midnight. The day of surgery, you and the recipient go directly to the Same Day Surgery Suite at 6 a.m. The suite is on the eighth floor of the hospital, near the main elevators. There, the staff will start an intravenous (IV) line through which medications will be given to you during surgery. A patient escort will take you to the operating room when it is time for your surgery. The transplant coordinator will tell you when your surgery is scheduled. Shortly after arriving in the operating room, the anesthesiologist will give you a medication through your IV to put you to sleep. Surgery usually takes two to three hours. Back to Top What happens after surgery? You will wake up in the recovery room feeling groggy and a little uncomfortable. You will have an oxygen mask on and a catheter will be draining urine from your bladder into a collecting bag. It is important for the medical team to make sure your kidney is producing plenty of urine. The catheter usually stays in for one day so that your urine output can be measured. You will receive nourishment and fluids through your IV until you are able to take liquids by mouth. Medicine for pain will be given by your nurse when you request it. Or, you may have a " patient controlled analgesia " device. This pump, connected to your IV, delivers a small amount of pain medicine when you push a button. Many patients prefer to control the amount of pain medicine they receive. You will be encouraged to get out of bed as soon as possible -- usually the day after surgery. During the rest of your hospital stay, you will be encouraged to walk as much as possible. You may be fairly uncomfortable the first two or three days, but that is normal. You will stay in the hospital for two days. You will be scheduled for a checkup with the surgeon or your doctor one week following surgery. Back to Top What should I expect during my recovery at home? When you go home, your activities will be limited. You should not lift anything heavier than 25 pounds for the first six weeks. You may find that you need frequent naps for the first few weeks. Listen to your body and do what it tells you. You should not plan on returning to work until seven to ten days after your surgery, depending on the type of work you do. Walking is very good exercise and is encouraged. Don't do anything that feels uncomfortable. If you have any questions regarding your condition, check with your doctor. Take the time you need to recuperate fully. Back to Top What emotions do donors say they feel after the surgery? Many donors say they feel positive because they have helped the recipient. Even in the rare instances where the transplant is not successful, donors say they benefit by knowing that they did their very best to help a relative or friend. A small minority of kidney donors have negative or mixed feelings after surgery. It is important that you learn as much about donation as possible and discuss any questions or concerns with your family and the transplant team before making your decision. Back to Top Who pays for your medical costs? As a donor, your medical costs are covered by the recipient's insurance. Most insurance companies pay 100 percent of donor's medical bills, including pre-transplant evaluation, hospitalization and follow-up medical care for at least one year after the operation. If the recipient's private insurance will not cover your costs and if the recipient is eligible for Medicare's End Stage Renal Disease (ESRD) program, your medical bills will be covered by Medicare. If the recipient does not have Medicare before the transplant and private insurance does not cover the full amount, the Medical Center will be responsible for all donor bills not covered by private insurance. It is important to discuss financial issues with the transplant financial coordinator. Back to Top Are there any expenses not paid by private insurance or Medicare? Generally, public and private insurance programs will not pay for travel and lodging expenses, lost wages, child care or daily living expenses incurred during pre-surgery testing and follow-up visits after the operation. It is important to discuss the potential financial consequences of donation with the transplant financial coordinator. For more information call: Transplant Program: Toll-free patient information: 1- Back to Top If you would like to make an appointment or talk to someone about our services, please call or 1-. Home Health Info Our Physicians Our Services Our Hospitals News Glossary Getting Here Make Appt. Translator E-mail this Page Contact Us UNIVERSITY OF MARYLAND MEDICINE 22 South Greene Street | Baltimore, MD 21201 ph: 1- | TDD: | Disclaimers © 2003 UNIVERSITY OF MARYLAND MEDICAL SYSTEM This site developed and maintained by Public Affairs. Information Guide Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2004 Report Share Posted September 21, 2004 Great site Louis. Very informative. Thanks for the info. My patient happens to be a kidney recipient, but I think the problem is with both. Thanks Pat Hogan -----Original Message-----From: Louis Sent: Tuesday, September 21, 2004 4:01 PMTo: TxFinancialCoordinators Subject: Q & A for Kidney DonorsSee our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2004 Report Share Posted September 22, 2004 Great site! Thanks for sharing it. Q & A for Kidney Donors Quote Link to comment Share on other sites More sharing options...
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