There are currently more than 100,000 people on the national organ transplant list, waiting and praying for a call that will save their lives. According to the United States Health Resources & Services Administration (HRSA), each day, 17 of those people will die waiting for an organ transplant.
While it’s a sobering reality, there is hope. In 2023, more than 46,000 transplants were performed in the United States, according to the United Network for Organ Sharing (UNOS). While most of those donations will come from deceased donors, some urgent needs can be met by a “living donor” when organs and organ tissue are donated by someone still alive.
“Kidney donation is the most common living organ donation we see,” explains Min Zhou, a nurse practitioner with Northwell Health’s North Shore University Hospital Transplant Center. According to HRSA, kidneys represent the most significant number of patients on the transplant list in 2023 at more than 88,000, and, of that number, roughly 25% of the need was met by living donation.
As part of her job, Zhou works with living donor candidates to determine eligibility and guides them through the process before, during, and after a transplant.
Considering becoming a living kidney donor? Here are things Zhou suggests keeping in mind:
There are different types of living donors: “Direct donors come to us with the name of a person they’d like to donate an organ to,” says Zhou. Typically, this means a person wants to donate an organ to someone they have an emotional or blood connection with, like a close friend or family member. Direct altruistic donors may also have the name of someone they want to donate to in mind but not a person they know directly. “They may learn about the recipient through social media or a post in a local store looking for a match,” Zhou explains. Non-direct altruistic donors can also be donors who don’t have a specific recipient in mind but hope to be a match for someone in need.
First, the donor and recipient are checked for blood type and immune system compatibility. If a recipient has a willing living donor but the donor is not a match based on blood type or immune system typing, then a kidney exchange, swap, or paired donation is an option.
A kidney exchange registry is a confidential database of incompatible recipient/donor pairs waiting to be matched with a compatible recipient/donor. The transplant center may utilize a registry for the kidney swap program.
It’s illegal to force—or coerce—someone into organ donation: Whether through financial incentives or other tactics. Zhou says this is one of the first things her team evaluates when reviewing living donor candidates.
However, despite being unable to receive financial compensation, living organ donors can be compensated for their time if they qualify.
“If the donor loses wages because of the process or has a financial need for travel expenses—for example, if they’re flying into another state to donate—they may qualify for assistance,” Zhou explains. “One of the assistances is the National Living Donor Assistance Center—or NLDAC.” The amount the donor receives is based on both the donor’s and recipient’s income levels, but it would not exceed the cost incurred for travel expenses and wage losses.
Only some people who want to be a donor are eligible: When evaluating applicants as living donors, Zhou and her team assess candidates medically and look at their current employment, financial situation, and support system. “It’s our job to ensure that their quality of life is not affected after donation,” Zhou explains.
The success rate of a kidney transplant is above 95%: Zhou credits this success to the pre-testing and screening required for living donors, the minimally invasive laparoscopic surgery technique, and the diligent monitoring of the recipient’s health.
For those receiving the transplant, these surgeries are both lifesaving and life-changing. “Transplant recipients go from being on dialysis to being independent,” says Zhou. “They can travel, live normal lives—it’s a huge difference.”
The process: Surgery is scheduled once a living donor has been evaluated, matched, and approved. The donor undergoes pre-surgical testing and a final crossmatch.
Typically, donors stay in the hospital for two nights following the surgery and can be discharged on day three.
For the first few days after surgery, donors may need prescription pain medication, but other than that, there aren’t any medications donors need to take consistently. It usually takes three or four weeks for them to return to normal.
If you’re considering becoming a living donor, Zhou encourages you to familiarize yourself with the process before applying.
“Be clear about your motivation, and learn about the risks of the donation procedure and the qualifications,” she says.
Zhou recommends that interested donors also speak with others who’ve already gone through the process to get a better picture of what it involves. Sites like transplant centers, the National Kidney Foundation, and UNOS are all great resources for connecting with experienced living donors.
“Living organ donors are special people,” says Zhou. After all, each donation represents one less name on the list—and another life saved.
