Overview

A living-donor kidney transplant is a surgical procedure in which a healthy individual donates one of their kidneys to someone with kidney failure. Since a person can live with just one kidney, this type of transplant provides an alternative to receiving an organ from a deceased donor.

Donors can be family members, friends, or even strangers. In the U.S., approximately one-third of kidney transplants each year come from living donors, while the remaining two-thirds come from deceased donors.

Why It’s Done

People with end-stage kidney disease have kidneys that no longer function properly, preventing the body from effectively removing waste from the bloodstream. To survive, they need either dialysis—a procedure that filters waste from the blood—or a kidney transplant.

For most individuals, a transplant is the preferred option as it offers a longer life expectancy and fewer dietary restrictions compared to dialysis.

Benefits of a Living-Donor Kidney Transplant

Opting for a kidney from a living donor has several advantages over receiving one from a deceased donor:

• Shorter waiting time – The national transplant waiting list is lengthy, and getting a kidney sooner can prevent further health deterioration.
• Avoiding or delaying dialysis – A timely transplant can allow some patients to avoid dialysis entirely.
• Higher success rates – Living-donor kidneys generally function better and last longer than those from deceased donors.
• Planned surgery – Unlike deceased-donor transplants, which occur when an organ becomes available, living-donor transplants can be scheduled in advance.

Risks

Like any surgery, a kidney transplant carries certain risks, including:

• Pain
• Infection at the incision site
• Bleeding and blood clots
• Organ rejection (symptoms may include fever, fatigue, decreased urine output, and pain near the new kidney)
• Side effects from anti-rejection medications, such as weight gain, acne, excessive hair growth, increased infection risk, and a slightly higher risk of developing cancer

Preparing for a Living-Donor Kidney Transplant

If your doctor recommends a kidney transplant, you’ll be referred to a transplant center. You can choose a center yourself or select one from your insurance provider’s preferred list.

At the transplant center, a medical team will conduct a thorough evaluation to determine if you are a suitable candidate. This assessment includes:

• A complete physical examination
• Imaging tests (X-rays, MRIs, or CT scans)
• Blood tests
• Cancer screenings
• Psychological evaluation
• Review of your financial and social support system
• Additional tests based on your medical history

Finding a Living Kidney Donor

Family members are often preferred donors due to a higher likelihood of compatibility, but friends, coworkers, or even strangers may also donate.

Potential donors must undergo a detailed medical evaluation to ensure compatibility. If a donor is not a match, alternatives include:

• Medical treatment – Special treatments may help your immune system accept a non-matching kidney.
• Paired donation – If your donor is not a match, they can donate their kidney to another recipient, while you receive a compatible kidney from a different donor. These exchanges can involve multiple donor-recipient pairs.

The Transplant Surgery

Once you and your donor are cleared, the transplant team will schedule the procedure. Before surgery, both you and the donor will undergo a final evaluation.

During the surgery:

• The donated kidney is placed in your lower abdomen.
• Blood vessels are connected to ensure proper circulation.
• The ureter (which carries urine) is connected to your bladder.
• Your original kidneys are typically left in place unless they cause complications.

Following surgery, you’ll stay in the hospital for several days while your medical team monitors your recovery and provides guidance on medication and kidney care.

Life After a Kidney Transplant

A successful transplant restores your body’s ability to filter waste naturally, eliminating the need for dialysis. However, lifelong medication is required to prevent organ rejection.

Since these medications weaken the immune system, you’ll be more susceptible to infections. Your doctor may prescribe additional medications to help prevent bacterial, viral, and fungal infections.

Important Post-Transplant Care

• Take all medications as prescribed – Missing doses can increase the risk of organ rejection. If you experience side effects, consult your transplant team immediately.
• Monitor your health – Watch for signs of rejection or infection, such as fever, fatigue, or changes in urination.
• Get regular screenings – Immunosuppressive medications increase the risk of skin cancer and other conditions, so regular checkups with specialists are essential.

Final Thoughts

A living-donor kidney transplant can be a life-changing solution for those with kidney failure, offering a better quality of life compared to long-term dialysis. Although the process requires careful planning and lifelong medication, the benefits often outweigh the risks. If you are considering a kidney transplant, speak with your doctor to explore the best options for you.