Living Organ Donation

Topic Overview

Introduction

More than 100,000 people in the United States are waiting for an organ to become available for a transplant that can save their lives. Many organ donors are living donors.

How can you be a living organ donor?

Most people can be organ donors. Many people choose to donate an organ upon their death. But a person can donate certain organs while he or she is still living. These people are called "living donors."

A living donor needs to be:

• In good general health.
• Free from diseases that can damage the organs, such as diabetes, uncontrolled high blood pressure, or cancer.
• At least 18 years old, typically.

Who can you donate to?

You can direct your donation to someone you know: a family member, a friend, a coworker, or a person that you know needs an organ. Or you can donate to someone in need by donating to the national waiting list. You may also want to talk with your doctor about paired organ exchange. This program helps find organ matches between people who may not know each other. Medical tests will show if your organ is a good match with the recipient.

How is it decided who gets priority for transplants?

If you do a directed donation, your organ goes only to the person you name. If you donate to the national waiting list, your organ will go to an anonymous person on the list. If you donate to the national waiting list, the Organ Procurement and Transplantation Network uses a computer to match your organ with possible recipients based on things such as tissue and blood type.

What organs can you donate?

Living donors can donate these organs:

• A kidney
• A lobe (part) of a lung
• A lobe of your liver (It will grow back to normal size in your body and in the recipient's body over time.)
• A section of your intestine
• A part of your pancreas

You can also donate bone marrow, umbilical cord blood, and peripheral blood stem cells.

What's the process for making an organ donation?

When you are a possible living donor, your rights and privacy are carefully protected. It's also very important to be informed about the risks of donating an organ. To help you make the best decision for you, you will have an independent donor advocate (IDA) who will guide you and answer your questions.

Here are the steps for making a donation:

• Contact the United Network for Organ Sharing (UNOS) at 1-888-894-6361 or go online at www.unos.org to get more information and to locate the nearest transplant center.
• Learn about the risks. Risks vary with the organ donated and from person to person.
• Complete a medical evaluation that includes these tests:
  • Cross-match for transplant. This is a blood test that shows whether the recipient's body will reject your donor organ immediately. The cross-match will mix your blood with the recipient's blood to see if proteins in the recipient's blood might attack your donated organ.
  • Coombs antibody screen. This test measures whether the recipient has antibodies against a broad range of people. If so, it means there is a higher risk of rejection, even if the cross-match shows a good match.
  • Blood type. This is a blood test that shows which type of blood you have—type A, B, O, or AB. Your blood type should be compatible with the organ recipient's blood type. But it is sometimes possible to transplant an organ between people with different blood types.
  • Tissue type. This blood test shows the genetic makeup of your body's cells. We inherit three different kinds of genetic markers from our mothers and three from our fathers. Tissue type sometimes plays a role in matching an organ recipient to a donor.
  • Mental health assessment or social network evaluation. Many emotional issues are involved in donating an organ. A mental health assessment or a social network evaluation may be done. These things look at your emotional health, your social support, and how donation would affect you and your family. They also show if you understand your own interests, the future effects on your health, and whether you're feeling pressure to donate from another person or from a sense of obligation.

Two types of surgery are commonly used to remove an organ or a portion of an organ from a living donor.

• Open surgery involves cutting the skin, muscles, and tissues to remove the organ. When open surgery is done, the person may have more pain and a longer recovery time.
• Laparoscopic surgery is a procedure in which a surgeon makes a number of small incisions and uses scopes to remove the organ from a living donor.

Throughout the planning process, know that it's never too late to change your mind about donating an organ. Talk with your IDA and others you trust to be sure you're making the right decision for you. Your long-term health is just as important as that of the person who will receive your donation.

What are the facts about living organ donation?

You don't have to be in perfect health to donate an organ. As long as the organ you donate is healthy, there are a lot of health conditions that won't prevent a successful donation.

Living organ donation can be risky for both the donor and the recipient. Removing an organ, or a part of an organ, from your body involves major surgery. There is always the risk of complications from surgery, such as pain, infection, pneumonia, bleeding, and even death. After the surgery you may face changes in your body from having removed one of your organs.

Living organ donation can be costly. Your medical expenses related to the transplant surgery will be paid for by the recipient's insurance, Medicaid, or Medicare. You may get help with some of your travel expenses, either through the recipient or the National Living Donor Assistance Center. But also think of your costs in terms of lost wages, child care, and possible medical problems in the future. Your own insurance premiums may rise after the surgery, and later you might have problems getting or keeping health, life, or disability insurance. Check with your insurance provider for more information about how your donation may affect your coverage.

Living organ donation is rewarding. After a successful transplant, most donors feel a special sense of well-being because they have saved a life.

All major religions allow organ donation. The Christian, Jewish, Muslim, Buddhist, and Hindu faiths encourage organ donation or leave it up to individual choice. Ask your spiritual advisor if you have questions about your religion's views on organ donation.