A donation is an act of courage and it requires immense determination and dedication to donate one’s organ to suffering relative (the recipient). The donor is the most important person in any living donor transplant program. The donor safety and well-being throughout the entire process of transplant and later in life is of utmost importance to us, as clinicians. The donor undergoes an exhaustive evaluation before being selected for donation. During this evaluation, if anything is found that may harm his well being in the future, the process is stopped. The present article will highlight the key features in the process of donation with emphasis on life after donation.
Which kidney is removed for donation?
Each person has a pair of kidneys located on the posterior abdominal wall below the ribs. Both the kidneys function more or less equally and anyone kidney of a healthy individual can be donated. As a part of donor evaluation, a test called “Renogram” is done to assess the split function of each kidney. Based on this, as a standard of care, the better functioning kidney is always left with a donor.
Is a single kidney able to perform the function of both the kidneys?
After one kidney is removed for donation, the remaining kidney undergoes a process known as “Compensatory Hypertrophy” i.e. it increases in size and takes over the function of the other kidney as well. The donor leads a normal life after donation.
How long is the process of donation?
It usually takes 2-3 weeks in the entire process of donation. This includes complete pre-operative work-up, preparation of legal documents, authorization by the appropriate committee and the surgery.
What is the length of hospital stay and recovery after surgery?
The donor is admitted a day before the surgery. The kidney is removed in a minimally invasive manner i.e. through keyholes. As a result, there is minimal pain, recovery is very fast and there are hardly any problems after the surgery. The donor is usually discharged after 3-4 days. The sutures are self-absorbable and do not require removal. The scars are barely visible after some time. Some medications like antibiotics, antacids, and painkillers are prescribed for a few days at the time of discharge and no long-term medications are required (unlike recipient). The donor can resume his work as early as 7 days, but this is individualized.
How is the follow-up after the surgery?
A regular well-designed follow-up is an integral part of any surgery. It is mandatory for the donor; as living with one kidney may be tricky if that kidney is not properly taken care of. Most of the transplant centers have well-designed follow-up protocols. In our practice, it requires the donor to come back for follow-up at 1-month, 3-month and then annually post-donation. Each visit may require some tests to ensure the donor’s well-being. Studies have shown that with regular follow-ups, the donor population lives longer and have a better quality of life than the age-matched general population.
What should I do in case I develop any medical or surgical illness later in life after donation?
In case the donor develops any problems (unrelated to the donor surgery or the act of donation), which may be as simple as diarrheal illness or as difficult as acute appendicitis requiring emergency surgery. There is no need to panic, as you are as normal as any other individual with the same illnesses. Seek medical advice from your family physician without any delay. Please communicate to your treating doctor about your donation and the fact that you have the only kidney. This will help him in managing your problems in a better way and he will understand the need to avoid certain medications that are harmful to the kidneys.
What precautions do I need to take so that my remaining kidney stays healthy for life?
You need to have regular follow-ups as mentioned previously. Besides, avoid any over-the-counter medications like painkillers. You should take medications for common ailments under medical supervision. Make sure you hydrate yourself well all the time. With these precautions, you are sure to live a healthy life.
Gifting life to someone is Godly. Don’t leave this chance to give this greatest gift to the world. Talk to people who are donors or reach them through social media. Know and read as much as possible about living donations. Be an inspiration, be a hero…be a donor!!!
Dr. Vikas Jain, Senior Consultant – Kidney Transplant – Adult, Kidney Transplant – Paediatric, Urology, Dharamshila Narayana Superspeciality Hospital, Delhi & Narayana Superspeciality Hospital, Gurugram