Living kidney donation provides those waiting for transplantation with a viable alternative to a deceased donor transplant.

Living donors must be over 18 and generally under 70 years of age, in good general health without any evidence of high blood pressure, diabetes, cancer, kidney disease, heart disease or hepatitis. Gender and race are not factors in determining who can donate.

The first step in the evaluation process is to determine whether or not a potential living donor is in good health and has a blood type that is compatible with the recipient. If the donor and the recipient have compatible blood types, the donor undergoes a medical history review and a complete physical exam, including blood and urine tests, a chest X-ray, and electrocardiogram. Potential donors who are female may also undergo a gynecological exam and mammography to make sure there are no underlying medical conditions. If the health screening and lab tests are normal, further testing for compatibility between the donor and the recipient is performed.

There are many advantages to living kidney donation which include:

• The kidney from a living donor is usually healthier than an organ from a deceased donor and will function better and last longer. The functioning life span of a living kidney donation is generally 15-20 years as compared to 10-15 years for a deceased kidney donation.
• The length of time it takes for an organ to become available is significantly reduced when the organ comes from a living donor.
• Living donor kidney transplant also frees up a spot on the recipient list, shortening the wait time for someone else who needs a kidney.
• It is possible to have surgery much earlier in the course of disease, before dialysis is required.
• Surgery can be scheduled when both the donor and the recipient are in the best health possible.
• The time between recovering the kidney and transplanting is minimized.
• A kidney from a living donor works immediately.
• Transplants from living donors are often more successful than transplants from deceased donors because there is a better tissue match between the living donor and the recipient.
• The higher rate of compatibility also decreases the risk of organ rejection
• Many living donors say making a contribution to the improved health of another individual is a very positive psychological experience.

There is a slightly increased risk of developing hypertension or high blood pressure as well as a slightly increased risk of kidney disease and kidney failure. In addition, there is the possibility of injuring the remaining kidney.

Although the success rate with living transplants is high, there is always the risk of a problem. These include rejection of the donor organ by the recipient or organ failure as a result of the same disease that caused the recipient's own organ to fail in the first place.

In Ontario, the cost of the donation, including laboratory, X-ray, physicians' and hospital charges, are paid by OHIP. The costs the donor incurs are the price of taking time off work, (if they do not have sick time coverage or employment insurance) as well as travel and childcare costs.

No. Living donation is a gift made by the donor to the recipient without any expectation of financial or material compensation.

Yes. It is called anonymous donation and describes a living kidney donor who is not related or known by the recipient. At this point, anonymous donation is available at some programs in the United States, as well as the B.C. Transplant Society. If you would like information about the status of anonymous donation programs in Ontario, speak to a TGLN living donation coordinator at 416-363-4001 or 1-800-263-2833.

Paired exchange is when two separate but willing donors are each unable to donate to their intended recipients due to blood group (ABO) incompatibility. In this program, the willing donors are matched with the other's respective recipient so that each recipient can receive a kidney with a compatible blood type.
This program is available as a pilot project between St. Michael's Hospital and Toronto General Hospital in Toronto.

Find out your blood type. If you don't know what it is, see your family physician and have a blood test. If you have a blood donor card, that is acceptable.

Yes. One kidney is adequate to support adults beyond 90 years but a living kidney donor must be at least 18 years old.

The transplant is scheduled at a time when the donor and the recipient are in optimal health.

Living kidney donation is the most common living donor procedure and can be done as an open nephrectomy (flank surgery) or laparoscopic surgery. In flank surgery, an incision of about 10 inches (25.4 centimeters) is made on the side along the bottom of the lower rib to the middle of the abdomen. (The left kidney is most often removed because it has longer blood vessels and is not obstructed by the liver.) Alternatively, a newer procedure known as "laparoscopic nephrectomy" may be performed resulting in the kidney being removed through a small incision below the naval.

The open nephrectomy or flank procedure is 2-3 hours; laparoscopic procedure is about 3-4 hours.

For open nephrectomy, the hospital stay is 4-6 days with about six to ten weeks required for a full recovery. For laparoscopic nephrectomy, the hospital stay is 3-4 days and in many cases, the donor can return to work in 3-4 weeks.

Yes. The surgeon will see the donor two weeks after surgery. Approximately 6-9 weeks after surgery, an evaluation of blood and urine is scheduled to make sure that the donor's remaining kidney is functioning well. This evaluation does not require a hospital stay.

Yes. There is evidence that donation has little if any long-term impact on health since the remaining kidney enlarges after surgery to do the work formerly done by two kidneys.

Give your decision careful thought before excluding it as a possibility. Obtain as much information as possible to make an informed decision. The option of donating must be voluntary and free of coercion. If you are feeling pressured to donate, it makes the decision difficult. Speak with the transplant team or living donation coordinator, who will support you in your decision.

Studies indicate that the consequences of donating a kidney are minimal and that the slightly increased incidence of high blood pressure and proteinuria seen in living kidney donors can be effectively managed with appropriate follow-up care, including regular physical exams and blood and urine tests.

Any woman who is a living kidney donor who wishes to become pregnant should inform her physician so that kidney function can be monitored during pregnancy.

If you are not able to be a living kidney donor or if you decide that living kidney donation is not for you, you can still help people awaiting a deceased donation transplant by registering your consent to donate. Contact us or visit http://beadonor.ca. Make sure you speak to your family about your decision.

A blood test determines your genetic makeup by testing the white blood cells for what is known as "human leukocyte antigens" or HLA. Although tissue typing remains important, the development of more effective anti-rejection drugs has reduced the importance to the point that success can be found without any HLA match.