Donating a kidney? Here’s why you’ll be just fine (common myths debunked)

Renal transplant is the treatment of choice for most patients with end stage renal disease. Renal transplant involves the transfer a one kidney from a living donor or a brain dead cadaveric donor to a patient with end stage renal disease (ESRD). The achilles heel of renal transplant is the availability of a suitable renal donor. The demand far outruns the supply of organs for renal transplant. However the renal donor is the true hero/heroine of the renal transplant program. There are many myths surrounding the process of live renal organ donation in India which I will try to address in this article.

Donating a kidney does not reduce the life expectancy of the donor, infact the renal donors outlive an average person. The reason for this is that all renal donors are extensively evaluated for the presence of any chronic illness, infections and malignancies and only when they are normal and have enough renal reserve they are allowed to donate 1 kidney.

The process of renal donation is entirely voluntary, the donor can change their decision at anytime during the workup process prior to the transplant surgery. No one can force a person to donate his/her organ.

The estimated risk of kidney failure after donation is 3 per 1000 donors. Donors have lower rates of kidney failure than the general population (0.9% Vs 3.26%) but 0.14% higher lifetime risk compared to healthy non donors. In short, though the chances of a renal donor developing renal dysfunction after donation is very low it is not zero. Moreover every donor is counseled about their individual risk associated with donation.

Donors must be healthy and can donate primarily on a basis of health, not age

Usually a renal donor is discharged within a period of 3 to 5 days after surgery. They should be able to return to regular activities and exercise about 4 to 6 weeks after surgery.

Ordinarily there will be some pain immediately after the surgery, which will diminish within a few days and can be managed adequately with oral medications.

The kidney donors are advised to lead a healthy and active lifestyle, they are prescribed analgesics and stool softeners for a few days after the surgery. They need not be on any long term medications after renal donation.

A living donor doesn’t need to be biologically related to the recipient (though biologically related donors like mother, father, siblings are likely to be better matched). Donors must be willing to donate, have a blood type compatible with recipient’s and not suffer from chronic illness like diabetes. However organ donation by force or for any material gain is illegal in India and punishable by law. All transplants where donors are not first degree relatives as per the THOA act must be cleared by the government authorization committee and only after their approval transplant can be done.

Commonly donor surgery is done by laparascopic route using key holes, however a small incision is made in the lower abdomen to remove the kidney outside the donor’s body. This incision is usually around 3 inches in length and fades with time.

A female donor is usually advised to wait for 6 to 12 months after donation to become pregnant. Though the risks of gestational hypertension are slightly higher for renal donors than the general population, renal donation per se is not a contraindication for pregnancy in an otherwise healthy young women.

Renal organ donor is the true hero / heroine of the transplant program. They undergo various tests, a surgery and endure pain not for their benefit but for the betterment of the recipient which is truly a remarkable act of bravery. Decision to donate an organ is a significant decision and understanding these fears can help individuals make informed choices. Hope this article was useful in dispelling some of the myths surrounding organ donation in our country. Hats off to all voluntary kidney donors!!
Dr Navinath M, MD(Med)(AIIMS), DM(Nephro)(AIIMS), DNB(Nephro), MNAMS, Consultant Nephrologist and Renal Transplant Physician, Asian Institute of Nephrology and Urology, Nungambakkam, Chennai.