About Kidney Donation
ABOUT KIDNEY DONATION
Live kidney donation typically offers the recipient:
- A shorter wait for a new kidney (the average wait in the US is 6-8 years for a deceased donor kidney transplant).
- A better match with less chance of rejection (live donor kidneys are shown to last longer than kidneys from deceased donors).
- The ability to plan the surgery on an elective basis rather than as an emergency procedure.
Who can be a kidney donor?
- Obesity (BMI >32)
- Age (most donors are over 21)
- Uncontrolled High Blood Pressure
- Cancer (within 2 years)
- Strong family history of kidney disease
- Severe /untreated psychiatric illness
- Active alcohol/drug abuse
If a donor wishes to donate directly to a particular recipient – blood and tissue typing is necessary early in the process. However, compatibility is no longer a barrier due to the availability and success of robust paired exchange programs.
ABOUT THE KIDNEY DONOR EVALUATION
Kidney Donors must go through an extensive medical and psychosocial evaluation to ensure that undergoing elective surgery is safe AND that there are no health issues that put the donor at increased risk of developing kidney disease in their lives.
The potential kidney donor will be evaluated at the center where their intended/matched veteran recipient receives medical care. Travel, lodging, meal reimbursements are covered by the VA and Military Hospitals. Should there be a gap in coverage DOVE can assist with coordination of community resources and ensure coverage for these expenses. If a donor cannot travel to the intended recipient’s center there are options such as remote donation or an alternate recipient, in closer proximity to donor, can be located.
A comprehensive donor medical evaluation is paid for by the veteran’s insurance coverage or the transplant facility.
A donor should expect to undergo a 1 or 2 day evaluation at the transplant center.
During this visit the donor will meet with the interdisciplinary kidney donor team. This team consists of:
- A Donor Coordinator (The coordinator will be your point person and manage all aspects of the evaluation)
- A Nephrologist (An MD who specializes in kidney disease)
- A Social Worker (The SW makes sure you are emotionally and logistically able to donate and can advocate for resources if needed)
- A Donor Surgeon (Will perform your donor nephrectomy).
Lastly, you will meet with:
- A Donor Advocate (The Advocate ensures you are under no undo external or internal pressure in donating. The ILDA is independent of the rest of the team.)
In addition to meeting with the donor team – all donors will undergo lab work and have to provide samples of blood and urine in order to assess their own kidney function and rule out any health concerns. Their blood work will also confirm blood type and genetic tissue typing which determines compatibility with potential recipients.
The final tests included in a standard donor evaluation are imaging and diagnostic tests of the abdomen and the heart.
- A Cat Scan or MRI – to assess anatomy of kidneys and vasculature.
- Chest X Ray – to assess lungs.
- Cardiac tests – depending on age there are different tests to assess the health of the heart.
ABOUT KIDNEY DONATION SURGERY:
Most kidney transplant surgeries are done laparoscopically . A laparoscopic surgery is a surgery method that uses very small cuts on the body and a thin lighted tube to look inside the body. In a laparoscopic kidney donor surgery, the surgeon makes small cuts on the donor’s stomach, and the kidney is removed through an incision just big enough for it to fit through. This operation takes 2-3 hours. The recovery period after laparoscopic surgery is much shorter than after a traditional open surgery. There are also fewer complications with laparoscopic surgery.
As a kidney donor, you can generally expect to stay in the hospital for two days after surgery. Most kidney donors resume normal activities after four to six weeks, depending on the physical demands of their daily living and work tasks. You may not be able to drive for up to two weeks. You may have lifting restrictions for at least six weeks. Many donors have reported experiencing fatigue for varied periods of time.
PROTECTIONS FOR LIVING DONORS ENACTED INTO LAW:
Over the past 10 years there have been great strides made in the expansion of benefits and protections for living organ donors. These protections has been further strengthened by the Living Donor Protection Act of 2021.
The Living Donor Protection Act of 2021 will protect living organ donors and promote organ donation in three easy, low-cost ways:
- Prohibits life, disability, and long-term care insurance companies from denying or limiting coverage and from charging higher premiums for living organ donors.
- Amends the Family and Medical Leave Act of 1993 to specifically include living organ donation as a serious health condition for private and civil service employees.
- Directs the U.S. Department of Health and Human Services (HHS) to update their materials on live organ donation to reflect these new protections and encourage more individuals to consider donating an organ.
PREPARING LOGISTICALLY TO BE A KIDNEY DONOR
It is illegal to pay for someone to be a living organ donor. However, The National Organ Transplant Act allows organ recipients or other organizations to help pay for their living donors’ travel, lodging, and lost wages in connection with the donation.
Coverage for Travel, Food, Lodging
Each transplant center is variable in what services and resources it offers to prospective living donors related to travel expenses. For instance, for donors who are giving to a veteran at a VA hospital or Military Hospital, all the travel, lodging and food expenses are reimbursed or provided by the hospital. Additionally, these centers often require the donor bring a primary support person with them to the evaluation and surgery – so all costs related to travel for the support person are covered as well.
For donors who are giving to a veteran at a private center – this coverage is not usually available through the hospital. However, there are resources available through organizations such as DOVE, National Living Donor Assistance Center (NLDAC), The National Kidney Registry (NKR) that may provide financial assistance for travel related expenses.
Coverage for Work Leave
Living kidney donation now specifically qualifies as a serious health condition under FMLA.
Federal Employees who are living organ donors are allowed 30 days of paid time leave as per the Organ Donor Leave Act (1999). If donor’s employers provide Short Term Disability – all prospective donors will qualify for this benefit for up to 3 months post donation.
For those donors who do not have paid vacation or access to disability insurance, there are resources through DOVE, National Kidney Registry, National Living Donor Assistance Program and other community organizations that can assist.
Below is a list of organizations, in addition to DOVE, that help fund logistical services to support a donor:
- National Living Donor Assistance Center: (Can assist with lost wages, travel and other expenses. Must apply 6 weeks prior to when needed.
- National Kidney Registry: (Any voucher donor through NKR is eligible or any transplant center that offers donor shield coverage as part of the program).
- American Kidney Fund: (Has up to $700 grant for assistance that can help cover non travel or medical expenses incurred as a result of donation such as child care assistance.
TAX DEDUCTIONS AND CREDITS AVAILABLE FOR LIVING DONORS
Many states have already enacted tax deductions or credits to living donors for unreimbursed expenses associated with donation.
There is pending federal legislation that would provide a federal tax credit of up to $5,000 for unreimbursed expenses, including lost wages, for living donors of kidney, liver, lung, pancreas, intestine or bone marrow.
For a state-by-state guide: