Living Organ Donation

Overview

You may be thinking about donating an organ to a family member or friend. Or you may want to donate an organ to help someone in need. Donating an organ while you're alive is called a "living donation."

Some people who are critically ill need an organ transplant to live. But there are a lot more organs needed than are available. One problem is trying to match a donated organ with the body of the person who gets the organ.

Make sure to think about how giving an organ may affect your emotions. If you're thinking about being an organ donor, you will be asked if you understand how it may affect you and your family. You will also be asked if you understand how it may affect your health. And you will be asked if you feel pressured to donate an organ.

For many people, making a living organ donation can be rewarding. After a successful transplant, most donors feel a special sense of well-being because they may have helped save a life.

What to know

• Most adults can become organ donors.
• You can donate to someone you know. Or you can donate to the national waiting list.
• Organs you can donate include a kidney or part of the liver, lung, pancreas, or intestines.
• You need a number of medical tests before you can donate.
• You don't pay for your medical costs.
• If you have questions about organ donation, talk to your doctor, a trusted friend, or your faith leader.
• Most religions allow organ donation.

If you're interested in donating organs or tissues, or if you want to learn more, contact the United Network for Organ Sharing (UNOS). Call 1-888-894-6361. Or go online at www.transplantliving.org to get more information.

Who can be a living organ donor?

• You don't have to be in perfect health to donate an organ, as long as the organ you donate is healthy.
• People of any age can sign up to be organ donors. In many states there's no minimum age. An adult might have to sign for someone under age 18.
• To be a living donor, you must be:
  • In good general health.
  • Free from diseases that can damage the organs. These include diabetes, uncontrolled high blood pressure, and cancer.
• If you are or may someday become pregnant, talk with your doctor. Donating an organ could affect your future pregnancies.

Who can you give an organ to?

You can direct your donation to someone you know. It could be a family member, a friend, a coworker, or a person that you know needs an organ. Or you can donate to someone in need by donating to the national waiting list. You may also want to talk with your doctor about paired organ exchange. This program helps find organ matches between people who may not know each other. Medical tests will show if your organ is a good match with the recipient.

If you do a directed donation, your organ goes only to the person you name. If you donate to the national waiting list, your organ will go to an anonymous person on the list. If you donate to the national waiting list, the Organ Procurement and Transplantation Network uses a computer to match your organ with possible recipients based on things such as tissue and blood type.

What organs can you donate?

Living donors can donate these organs:

• A kidney
• A lobe (part) of a lung
• A lobe of your liver (It will grow back to almost its original size in your body and in the recipient's body over time.)
• A section of your intestine
• A part of your pancreas

You can also donate bone marrow, umbilical cord blood, and peripheral blood stem cells.

Becoming a Donor

When you are a possible living donor, your rights and privacy are carefully protected. It's also very important to be informed about the risks of donating an organ. To help you make the best decision for you, you will have an independent donor advocate (IDA) who will guide you and answer your questions.

Here are the steps for making a donation:

• Contact the United Network for Organ Sharing (UNOS).

  You can call UNOS at 1-888-894-6361 or go online at www.transplantliving.org to get more information and to locate the nearest transplant center.

• Learn about the risks.

  Risks vary with the organ donated and from person to person.

• Complete a medical evaluation that includes blood tests.

  The test results can help match you to an organ recipient.

Throughout the planning process, know that it's never too late to change your mind about donating an organ. Talk with your IDA and others you trust to be sure you're making the right decision for you. Your long-term health is just as important as that of the person who will receive your donation.

Exams and Tests

Before you become a living organ donor, assessments will be done. These include:

Cross-match for transplant.

This is a blood test that shows whether the recipient's body will reject your donor organ immediately. The cross-match will mix your blood with the recipient's blood to see if proteins in the recipient's blood might attack your donated organ.

Coombs antibody screen.

This test finds out if the recipient has antibodies against a broad range of people. If so, it means there is a higher risk of rejection, even if the cross-match shows a good match.

Blood type.

This is a blood test that shows which type of blood you have—type A, B, O, or AB. Your blood type should be compatible with the organ recipient's blood type. But doctors can sometimes transplant an organ between people with different blood types.

HLA type.

This blood test shows the genetic makeup of your body's cells. We inherit three different kinds of genetic markers from our mothers and three from our fathers. HLA type sometimes plays a role in matching an organ recipient to a donor.

Mental health assessment or social network evaluation.

At these visits, an evaluator looks at your emotional health, your social support, and how donation might affect you. These visits can help give you information to understand your own interests, the future effects on your health, and if you're feeling pressure to donate from another person or from a sense of obligation.

Other screenings may be done, depending on the organ you're donating.

Surgery

Two types of surgery are commonly used to remove an organ or a portion of an organ from a living donor.

• Open surgery. This involves cutting the skin, muscles, and tissues to remove the organ. When open surgery is done, the person may have more pain and a longer recovery time.
• Laparoscopic surgery. This is a procedure in which a surgeon makes a number of small incisions and uses scopes to remove the organ from a living donor.

What are the risks?

Living organ donation has risks for both the donor and the person who gets the organ. It's major surgery to take out an organ or a part of an organ. There is always the risk of problems from surgery, such as pain, infection, pneumonia, bleeding, and even death. After the surgery, you may face changes in your body from having one of your organs removed.

Costs

Your costs for the transplant surgery will be paid for by the insurance, Medicaid, or Medicare of the person who gets the organ. You may get help with some of your travel expenses. This may be through the recipient or the National Living Donor Assistance Center. But also think of your costs in terms of lost wages, child care, and possible health problems in the future.

While it is very unlikely, your own insurance costs may rise after the surgery. And later you might have problems getting or keeping health, life, or disability insurance. Check with your insurance provider to find out how your donation may affect your coverage.