If you are waiting for a kidney transplant, you are likely familiar with living donation. But did you know that not all potential donors have to be a relative or friend? Siblings and family should be considered first when looking for kidney donors, but a stranger might end up as your best option. Altruistic or nondirect living kidney donation is when someone donates a kidney, but they don’t know the recipient. They are providing an organ out of the kindness of their heart for someone in need. The nondirect donor often starts a chain reaction of transplants. You can learn more about paired kidney donation chains on our blog.
Recently on our Transplant Discussion Group on Mayo Clinic Connect, we had a request for more information about nondirect donation and how it differs from direct donation from a family member or friend. Some information can be found on our website or our donor toolkit, but we’ve also asked Kay Kosberg, RN, CCTC, our Enterprise Kidney Paired Donation Coordinator, to answer some questions about nondirect donation. You might remember Kay from our blog What to Expect During a Living Donor Evaluation.
What are the differences between direct and nondirect donors other than the relationship piece? Are there any procedural or surgical differences?
All nondirect donors have an additional consult with a psychiatrist during their evaluation to further determine their motivation for proceeding with donation, examine any past mental health issues, and determine their support structure as they go through the process. There are no differences in the surgery.
Can the nondirect donor and recipient meet before surgery? If not, is there a waiting period after surgery before they are allowed to meet?
Nondirect donors don’t meet their recipient prior to surgery. Each donor and recipient are given the option to sign a release of information at the pre-operative appointment. If they choose to release their information, it is then shared once both surgeries are complete.
Is financial coverage for the surgery the same for direct and nondirect donors?
Yes, the evaluation, surgery, and some aftercare are all covered by the recipient’s insurance for both direct and nondirect donors. The donor would be responsible for their time away from work, travel and lodging expenses, and charges for any medical care needed that is unrelated to the donation.
If I want to be a nondirect donor, am I still able to designate my donation to a certain group (ex. only to children)?
It would be very rare that someone would be allowed to donate only to a certain group. Many people want to donate to children, but if there is a large age difference between donor and recipient, it isn’t typically ideal for a child to receive an older kidney. The match is based on blood type and genetic factors, plus many other variables the medical team would assess.
How often are nondirect donors used just for an individual and not part of a chain of transplants?
Nondirect donors are seldom used just to get one person transplanted. The majority of nondirect donors start a paired donor chain which can help multiple people get their second chance at life much sooner.
Since Mayo Clinic has three transplant programs across the country, if a nondirect donor starts a transplant chain, do those chains extend across campuses?
The majority of nondirect donors help start chains that may include recipients at one, two or all three of Mayo Clinic’s transplant centers. This is of great benefit to recipients because it means a larger donor pool to find the best match for each recipient which should help the kidney last longer.
Does Mayo participate with other national registries for donation chains?
Mayo participates with the National Kidney Registry (NKR), which is a national paired donor registry that facilitates matching donors and recipients. This, again, is a much larger donor pool to find the best match for the recipient. Your surgery, and your donor’s surgery, would remain scheduled at Mayo Clinic.
How do I sign up to be a direct or nondirect living donor?
Learn more by visiting our living donor toolkit.