Frequently Asked Questions

The recovery time after living kidney donation surgery will vary depending on several factors, including the type of surgery and the donor’s individual rate of recovery. Typically, a living kidney donor will be in the hospital for 2-6 days after donation, should not fly for a minimum of a week after donation and will need between 2 and 8 weeks of recovery time before returning to work. The more physical exertion the donor’s job requires, the longer the expected recovery time. For competitive athletes, we have heard some donors report that it took about a year before they were back to their pre-surgery performance levels.

You will be given a general anesthetic and will be asleep for the entire procedure. Most kidney removals (nephrectomies) are done using laparoscopic surgery, which is a minimally invasive surgery that uses small incisions and a special camera. In this case, the surgeon will make one or more incisions in your abdomen, carefully remove one kidney, then close the incision(s). Laparoscopic surgery typically results in a shorter hospital stay, less pain and scarring, faster recovery time, and fewer post-operative complications. In cases where laparoscopic surgery is not possible, you may have open surgery to remove your kidney. Your transplant center can give you the most current medical information about the specific surgery you will undergo.

Becoming a living kidney donor through the National Kidney Registry (NKR) gives you additional protections related to your kidney donation surgery, including coverage for post-surgical complications, kidney donation life insurance, donation disability insurance, legal representation, travel and lodging reimbursement, and lost wage reimbursement for those who qualify.

Requirements for kidney donation vary by transplant center. At a minimum, you must be 18 years of age, in good health, with normal kidney function and no major physical or mental illnesses. There are a number of other factors to consider, all of which will be addressed during the evaluation process should you decide to become a living kidney donor. You can easily apply to become a kidney donor using our online donor screening process, which lets potential donors complete a quick five-minute screening to determine if they are qualified to go on to the more comprehensive medical history questionnaire. Provided you are cleared to continue, these questionnaires will be followed by medical tests.

There is no official age limit for becoming a living kidney donor. It is harder to find a match for older donors, and harder for an older donor to qualify, but the National Kidney Registry (NKR) has had donors who were in their mid-70s when they donated. There is a minimum age, though. Depending on the transplant center, you have to be either 18 or 21 before you can donate.

If you are considering donating a kidney in the future, but are concerned your age may be an issue, the National Kidney Registry (NKR) Family Voucher Program lets potential donors donate a kidney immediately, then give vouchers to up to five family members, which includes spouses, biological or legal offspring, parents, and siblings. If any of the voucher holders need a kidney in the future, they can activate their voucher to receive priority consideration for a well-matched kidney from a living donor through participating National Kidney Registry (NKR) centers. Only one family voucher can be redeemed per donor. The Family Voucher Program is an excellent option for donors who do not have someone in immediate need of a kidney transplant, but who want to help others in need of a transplant by donating their kidney while still looking out for their family’s potential future kidney transplant needs.

Potential kidney donors with a Body Mass Index (BMI) over 35 are usually rejected as kidney donors. Those with a BMI of 30-35 may be at increased risk of developing chronic conditions after kidney donation and may be encouraged to lose weight before considering donation. If you are interested in becoming a kidney donor, but are concerned that you will not be accepted because of your weight, we encourage you to apply through the National Kidney Registry (NKR) Donor Care Network to determine your eligibility. The Donor Care Network offers a simple online donor screening process that lets potential donors determine whether they are medically qualified to donate and which centers will accept them as donor candidates. The initial screening process should take less than five minutes.

If you are interested in becoming a living kidney donor, you can start the process by applying through the National Kidney Registry (NKR), which is the largest paired exchange program in the world, and taking a short screening survey to see if you are generally qualified to donate. If you qualify, you will then be asked to complete a longer, more detailed medical history questionnaire. If you still qualify after this, you will need to do a few routine pre-donation work up labs which include a 24-hour urine collection test, a blood draw and providing a fresh urine sample. After this, you will be referred to a transplant center of your choosing. Applying through the National Kidney Registry (NKR) allows access to important protections for donors through their Donor Shield program.

The Donor Shield program helps donors by reimbursing lost wages for qualified donors, reimbursing travel and lodging expenses up to $2,000, as well as providing life insurance, disability insurance, coverage for uncovered complications, legal representation, and living kidney prioritization in the event you ever need a transplant after donating. To make things as convenient as possible for you, we also recommend that you donate as part of the Advanced Donation Program (ADP), which will allow you to donate to a stranger at a time that works best with your schedule and then provide a voucher to your intended recipient. If you don’t have an intended recipient, you can also take advantage of the Family Voucher Program, where you can donate and provide vouchers for up to five family members as a safeguard in case one of them ever needs a transplant.

Other options for donation include donating your kidney to a specific recipient (direct donation), donating to a stranger (Good Samaritan donation), or donating through traditional paired exchange, which works the same as the Advanced Donation Program (ADP) but where you would donate on the same day that your recipient receives their kidney. Because a matching recipient and matching donor must both be coordinated, this may require you to wait while we find the match.

When a donor is found to be compatible with a recipient, they can donate their kidney directly to that recipient. This is, logistically, the least complex type of donation. However, except in the case of siblings, the recipient can usually get a better-matched (i.e., statistically longer-lasting) kidney by entering paired exchange.

Non-directed donors, often called Good Samaritan donors, are donors who donate their kidney to a stranger. This donation often starts a chain where many patients get transplanted. Donors who intend to be non-directed donors should investigate and understand their options about the Family Voucher Program, which allows the donor to donate to a stranger now and start a chain, then name up to five family members to receive a voucher in the event one ever needs a transplant. To find out more about the Advanced Donation Program (ADP), click here.

When a donor is found to be incompatible with a recipient, or is compatible but wants a better match for their recipient, the donor and recipient can enter paired exchange. In paired exchange, the donor will donate their kidney to an unknown recipient and their recipient will receive a kidney from an unknown donor in exchange. Paired exchange can offer a much better match than direct donation, especially when paired exchange is done through a large donor pool like the National Kidney Registry (NKR). The National Kidney Registry (NKR) has facilitated more paired exchange transplants than any other exchange program in the world, and our improved donor-recipient matches result in more successful patient outcomes.

Because of the large number of potential donors that a recipient is compared with to find a match in a multi-transplant center paired exchange program, paired exchange is almost always the best option for finding the best possible kidney match. The only exception to this would be well-matched siblings who have a high genetic match score.

80% of the patients who enter paired exchange through the National Kidney Registry (NKR) are transplanted in under 90 days.

Advanced donation is kidney paired exchange separated in time. In the Advanced Donation Program (ADP), the donor donates first, to an unknown recipient, through the National Kidney Registry (NKR). That donation then provides a voucher for the recipient, which can be redeemed when that recipient is ready for transplant. Advanced donation allows the donor to donate when they are ready rather than having to wait for a match to be found for their recipient and themselves in paired exchange. This type of donation often starts a chain where many additional transplants are also facilitated by the Advanced Donation Program (ADP) donor.

A good match for a kidney transplant involves a number of factors, the most important being blood type and genetic matching (HLA). A good match is one that has very few antigen mismatches and, of course, is the same blood type. Age, weight, gender, and even donor blood pressure can be minor factors in finding the best match possible, though. Finding the best match is important because the better the match, the more likely it is that the kidney will last longer. This search requires a larger donor pool—the larger the pool, the more donors you could be compared with and the more probability there is of finding someone who is a good match. The National Kidney Registry (NKR) has the largest donor pool in the world, so working with the National Kidney Registry (NKR) increases your chances of finding a well-matched donor.

The cost of a kidney transplant depends on a number of factors, including the transplant center, location, and your level and type of insurance coverage. According to a 2017 report, the average estimated billed charges for a kidney transplant, including all pre- and post-transplant care, is $414,800. Depending on your insurance, a significant portion of those costs may be covered. Consult your insurance company and your healthcare provider regarding your specific case.

You should plan to be in bed for at least a day or two, and home within a week. Most kidney transplant patients can return to normal activities within 4-8 weeks after surgery.

Before the transplant, the patient will be put under general anesthesia; they will be asleep for the entire procedure. The surgeon then makes an incision in the recipient’s abdomen and places the donated kidney inside. The new kidney is then connected it to the blood vessels and bladder. Once this is done, the surgeon closes the incision. The patient’s original kidneys are usually left in place unless there is a medical reason to remove them. The operation typically takes 3-5 hours.

Kidney transplantation is a fairly common surgical procedure, with approximately 20,000 performed in the United States every year. This type of surgery generally has a high success rate and a low rate of complications. Kidney transplants from living donors generally last twice as long as those from deceased donors. Furthermore, those facilitated by the National Kidney Registry (NKR) have superior outcomes compared to average U.S. living donor transplant outcomes, which we believe is largely due to having the largest pool of living donors in the world. Having the largest pool allows the National Kidney Registry (NKR) to find better matches for recipients as there are more potential donors to compare the recipient against to find the best match. It also gives the National Kidney Registry (NKR) a unique capability to “repair” a real-time swap failure in which the recipient experiences complications during surgery and cannot receive a kidney until a later time.

If you need a new kidney, the most common way to get a kidney transplant is by registering on the deceased donor list. However, getting a kidney from a living donor is a better option, when possible, because it usually results in a shorter wait time and better outcome. If you find a donor willing to donate on your behalf, that donor may be able to donate directly to you, but it is often more beneficial for both you and the donor to enter paired exchange so that you can both get the best match possible. To reduce wait times and lower the risk of donor back-out, we recommend that all patients register at a transplant center that participates in the Advanced Donation Program (ADP), which allows the donor to donate on their own schedule and provide a voucher to the person needing a transplant. The Advanced Donation Program (ADP) also benefits the donor because they will be covered by Donor Shield, which includes lost wage reimbursement, travel and lodging reimbursement, coverage for uncovered complications, living kidney prioritization in the event your donor ever needs a transplant themselves after donating, etc. If you do not have an able and willing donor, we recommend registering at a transplant center that participates in the National Kidney Registry (NKR) Champion Microsite Program, which is a free service that helps kidney patients build a simple website to tell their story and find a donor. The site is sharable via social media and comes with 250 free business cards with the patient’s name and microsite URL that can be given out in the patient’s day to day activities.

If you need a living kidney donor, you can sometimes find a donor by asking friends and family members. If you are unable to find a donor among people you know, we recommend finding a transplant center that participates in our Champion Microsite program, which is a free service that helps kidney patients build a simple website to tell their story and find a donor. If you already have a donor that is incompatible, poorly compatible, or if you want to find a better match, you and your donor can participate in paired exchange, where your donor donates their kidney to another recipient in exchange for a compatible kidney for you. Another option is the National Kidney Registry (NKR) Advanced Donation Program (ADP), which allows the donor to donate on their own schedule and give you a voucher that you can use to receive a transplant from a well-matched living donor. The Advanced Donation Program (ADP) also benefits the donor because they will be covered by Donor Shield protections, which include lost wage reimbursement and living kidney prioritization in the event your donor ever needs a transplant themselves after donating, as well as several other important protections.

If you have advanced kidney disease, you may be eligible for a transplant. You will need to be evaluated by a transplant center, which will do a number of tests to determine whether you are a good candidate for a kidney transplant. In general, qualifications for kidney transplant include having chronic irreversible kidney disease, being on dialysis now or as a requirement in the near future and being able to tolerate major surgery. You may be ineligible for a kidney transplant if you have an additional life-threatening disease or condition, a history of chronic drug or alcohol abuse or a serious psychiatric disorder. If you are facing kidney failure and are medically qualified for a kidney transplant, the National Kidney Registry (NKR) can help facilitate a transplant, regardless of whether you have a matching, incompatible or poorly matched donor. Patients who receive a kidney transplant through the National Kidney Registry (NKR) are also covered by our 90-day kidney replacement policy, meaning that patients who are transplanted via the National Kidney Registry (NKR) and experience graft failure within 90 days of the transplant may be eligible for prioritization for a replacement kidney. This eligibility is subject to review/approval by the National Kidney Registry (NKR) Medical Board.

To get on the list for a deceased donor kidney, your name must be added to the national waiting list for organs from deceased donors, which is managed by the United Network for Organ Sharing (UNOS). There are more than 94,000 people in the United States on the waiting list to receive a kidney from a deceased donor, with an average wait time of 3-5 years. If you are able to find a donor willing to donate on your behalf, you will likely have a much shorter wait time for a kidney transplant by going through a paired exchange program.