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Over 100,000 people in America are waiting for an organ. Unfortunately, many may never get the call saying that an organ has become available. On average, 17 people die each day while waiting for a transplant. (Source: Donate Life America)

When someone donates an organ, it not only shortens the waiting time for the person receiving the organ, but reduces the pressure on the waiting list for others. Living donation gives hope to people waiting for a transplant.

The decision to become a living donor requires time and careful consideration. Our hope is the information in this toolkit will help. If you have questions about the information provided here, please visit our Q&A tab or post a comment and we’ll get back to you as soon as we can.

• Becoming a living donor
• What to expect as a donor
• Financial information
• Peer and social support
• Getting started

Becoming a living donor

Before you decide to become a living donor, you should understand fully what donation involves. You may choose not to be a donor at any time during the process. Your decision and reasons are kept confidential.

Living Donor Kidney Transplant

Most living kidney donors are a family member or friend. However, a donor does not need to be related to the person who receives the kidney. Some people who want to be kidney donors do not have a certain person in mind to receive the kidney. This is called a non-directed donation.

Often, non-directed donations start an “organ donation chain” where on average 15 kidneys are donated and received. In donation chains, the non-directed kidney donation goes to someone who had a donor lined up, but the donor was not a compatible match. That donor then “pays forward” their donation to someone else who is waiting.

Living Donor Liver Transplant

The liver is the only organ inside the body that can regenerate. Most living liver donors are a family member or friend; however, a donor does not need to be related to the person who receives the liver. Some people who want to be liver donors do not have a certain person in mind to receive the liver. This is called a non-directed donation. Even previous kidney donors can donate a portion of their liver.

Making the decision

Whatever your reason is for considering living donation, it’s important to understand the process and take time to make your decision.

To help you decide, you may want to reach out to family members, close friends, a social worker, counselor or someone else who has considered donating an organ. It may be helpful to ask yourself these questions:

• How do I feel about donating?
• Can I afford to take the time off work to rest and recover after surgery?
• Do I know enough about the process to make an educated decision?
• How may the donation change my relationship with the person I am donating to?
• Are there current health concerns that might keep me from donating?
• Do I have support from family members or close friends to help me through this process?
• How will I feel if it is determined I am not able to donate?
• Am I willing to take part in an organ donation chain if I’m not a match with the person I wanted to donate to?
• What if the organ that I donate doesn’t work well? How would I deal with that?

At Mayo Clinic, you will have an Independent Living Donor Advocate to help you determine if organ donation is the right choice for you. Another resource for you is Mayo Clinic Connect. In the transplant discussion group, you can meet people who are going through similar experiences and talk through your questions.

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What to expect as a donor

You’ve made the decision to become a living organ donor, now what? You and the person you are donating to (your recipient), will have a variety of appointments and tests to make sure you are a good match and to prepare for the transplant. Mayo Clinic is taking precautions to provide safe care based on each patients specific needs in regards to COVID-19. Click here to get the most up to date information. During your transplant evaluation, your care team will discuss how these precautions will impact you as a donor.

Tests and screening

The first test to see if you can be a living donor is to have a blood test at a laboratory or doctor's office that is local to you. This test helps determine if your blood type matches with the recipient. If your blood test results are acceptable, you then come to Mayo Clinic for tests and appointments to see if you can be a donor.

• A physical exam
• More blood tests
• Urine tests
• X-rays
• Kidney function tests
• Liver function tests
• Blood pressure tests
• Heart and lung function tests
• Tests to screen for cancer
• Other testing such as CT or MRI

While these tests are most commonly done, other tests may be done to help determine if donating is an option for you. More information about what to expect during your evaluation can be found on our blog.

The procedure

At Mayo Clinic, a living donor kidney transplant  is usually done using several small incisions instead of one larger one. This surgery is called laparoscopic surgery, which reduces the time needed to recover following surgery.

During a living-donor liver transplant, a surgeon places the part of your liver that is removed into the recipient after all of his or her liver is removed. It usually takes several weeks to several months for the liver to return to its normal size in both the recipient and the donor.

Risks

As with any surgery, there are risks involved. Some of the risks of this surgery are the same as any surgery: infection, bleeding and blood clots. Rare complications from surgery include heart attack, stroke and death. Your team will discuss risks with you in detail during your evaluation. Although there are risks involved, most donors do not have long-term problems after they donate.

It is common for people who have donated an organ to feel many emotions after surgery. You may feel worried, frustrated or angry. You might feel guilty or depressed if the person you donated to doesn't do well after surgery. These emotional responses are normal. Your donor team can help.

Recovery

Liver donors usually stay in the hospital for four to seven days after surgery, while kidney donors typically stay one to two days. Most people can resume normal activity within six weeks and can return to work within six to eight weeks, depending on the type of work. Ask your donor team what you can expect with recovery and follow-up care.

More detail about the living donor process can be found on our blog.

FAQs or Commonly Asked Questions

Should I stop taking my medication(s) before the evaluation or the surgery?

You should not stop any prescription medication unless advised to do so by your physician. Tell your donor team about all prescription and over-the-counter medications you are currently taking.

What should I bring with me to the hospital?

Bring a basic toiletry bag for your use in the hospital, as well as comfortable, loose fitting clothes for when you are ready to go home. Because the hospital will already have your insurance information, there is no need to bring any documentation unless you are specifically asked. Leave all jewelry and other valuables at home. You can read more about preparing for surgery on our blog.

Should I stop drinking alcohol?

Your alcohol use, both current and previous, is discussed during evaluation. If you are considering donating a portion of your liver, you may be asked to stop alcohol use before and immediately after surgery.

As a living donor, will I need a caregiver?

You are required to have a caregiver to be approved as a living donor. Talk to your social work team for more information on caregiving responsibilities and how to find the right person to help you before, during and after your surgery.

Financial Information

Expenses related to organ donation and the donor’s personal financial situation are important to consider. The following information will give you a better sense of what to expect.

Lost work time

Before your donation, tell your employer about the surgery. Ask about disability insurance coverage, and possible paid time off. Lost wages are not covered by the recipient's insurance.

Fortunately, in August 2018, the U.S. Department of Labor issued an opinion letter stating a healthy organ donor can use medical leave through the Family and Medical Leave Act (FMLA), to donate a kidney or part of your liver. Read more about the details of FMLA here, but essentially this means that living donors who are employees with FMLA have up to 12 weeks of unpaid, job-protected leave with their group health benefits maintained.

When returning to work, tell your employer about any restrictions or short-term special needs.

Donor and recipient costs

Most medical costs related to living donation are covered by the recipient’s insurance. These expenses are the living donor transplant evaluation, surgery, and post-operative care. Any medical issues found during your evaluation that are not related to the donation will need to be covered by your personal health insurance. For this reason, the transplant center may ask for your health insurance information before or during your evaluation. Future health problems may not be covered by the recipient’s insurance and life-long medical follow-up will become your financial responsibility.

Financial Assistance

Expenses such as travel, lodging and food/necessities and dependent care while you are at the transplant center for evaluation and surgery can be a struggle for some donors.

Two organizations that can provide information about finances related to living donation are:

• The National Kidney Foundation at www.kidney.org/transplantation/livingdonors/financial-insurance-issues
• The American Society of Transplant Toolkit at www.livedonortoolkit.com/financial-toolkit

For more information specific to your donation, contact your transplant social worker.

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Peer and social support for living donors

Involving your family and friends

Your family and friends can make a difference before and after you donate. By keeping them involved in the donation process, you open yourself up to encouragement, support and a better emotional recovery.

Finding a support community

Sharing your concerns, fears, struggles, experiences and triumphs with other donors and recipients can be comforting. Support is available through a variety of ways, including one-on-one support, group gatherings, online communities and more. Consider joining our online support group at Mayo Clinic Connect. You can also ask your nurse coordinator or social worker for support resources.

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Getting started

Once you have educated yourself about living donation and decided to proceed, you can start the first step online with our living donor form. Visit our blog post or Mayo Clinic’s Transplant Center and learn even more about how to begin the donation process.

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