Become a Living Donor
Why trust the most important decision of your life to anyone else?
A living donor transplant can decrease the time a patient will wait to be transplanted and it can provide a better quality organ. The kidney will usually work immediately after surgery and the patient will experience fewer episodes of rejection. Living donor transplantation can allow a recipient suffering from kidney failure to get a kidney transplant before starting dialysis, which can result in improved outcomes for the recipient.
We are the area’s only National Kidney Registry Donor Shield Program, providing a range of donor protections that are otherwise not offered in the region. This program provides a safety net for living kidney donors through a range of protections. Read more under the Donor Protections tab.
Becoming a living donor through MedStar Georgetown Transplant Institute requires several steps: evaluation, surgery, and recovery. If you have any questions, please call 202-444-3714
Living donor options include:
To become a living kidney donor, you will complete a comprehensive medical evaluation which includes: completing a donor questionnaire, lab work, evaluation with the living kidney donor team and diagnostic testing. If you are approved as a donor you may go on to donate your kidney. There are multiple pathways for kidney donation.
Living donor options include:
- Direct Donation: A donor who donates his or her kidney directly to their intended recipient
- Paired Kidney Exchange: A donor who donates his or kidney to another person and their intended recipient receives a kidney from another donor.
There are several types of transplant procedures:
- ABO and HLA-Compatible Kidney Transplantation: The donor and recipient have the same or compatible blood type, and the recipient’s immune system is compatible with the donor.
- ABO or HLA Incompatible Kidney Transplant: The donor and recipient have different or incompatible blood types or the recipient has antibodies against the donor, meaning the patient’s body would reject the donated kidney. In some cases, the recipient can be treated before and after the kidney transplant with medication or a treatment called plasmapheresis. Plasmapheresis removes antibodies in the recipient that would cause rejection of the kidney once transplanted.
- Kidney Transplantation with Highly Sensitized Recipients is done with patients who may be considered highly sensitized recipients, patients who have had extended time on dialysis, or patients who have had a previous transplant or pregnancy.
- Paired Kidney Exchange: iThe donor and recipient are not blood type compatible or HLA compatible and plasmapheresis is not an option for a safe transplant outcome.
MedStar Georgetown Transplant Institute is a national leader in kidney exchange and the management of recipients and donors who are incompatible. Only a handful of transplant centers in the United States offer this option to their patients.
Living Kidney Donor FAQs
Any healthy person can be a kidney donor. The donor does not need to be a family member. The donor can be a friend, an acquaintance, spouse, in-law, or even a stranger.
The donor must be:
- At least 18 years old
- Appropriate candidate for general surgery
- Meet medical, social, and psychological criteria set by UNOS
- Able to give informed consent
It is safe to live with one kidney and you will be able to resume all of your regular activities after surgery. Your remaining kidney will grow slightly larger to compensate for the donation of the other kidney. You will have scheduled follow-up visits with the transplant team to monitor your kidney function after surgery and will have lab work done 6 months, 1 year, and 2 years after your donation.
Donors who undergo surgery at MedStar Georgetown Transplant Institute will qualify for the following protections through the National Kidney Registry:
- Donation life insurance with a $500,000 principal sum, covering a period of one year post-surgery.
- Donation disability insurancewith a $1,500 maximum weekly benefit, covering a period of one year post-surgery, with a 30-day waiting period.
- Financial protectionfor complications that ensures donors are never asked to pay for a post-surgical complication that is a result of their kidney donation.
- Legal representation should a donor’s employment or health insurance be negatively affected by living donation.
Donors who undergo surgery at MedStar Georgetown Transplant Institute may qualify for the following protections through the National Kidney Registry:
- Lost wage reimbursementup to four weeks for donors who will have a loss of income during their recovery period.
- Travel and lodging reimbursement of up to $1,000. This includes expenses associated with the evaluation and surgery. Driving expenses are reimbursed at the IRS mileage rate and lodging covers a hotel near MedStar Georgetown Transplant Institute.
To learn more, speak with a living donor social worker at (202) 444-6038.
Paired Kidney Exchange
What is the Paired Kidney Exchange Program?
Paired kidney exchange (PKE) is a program that assists donor and recipient pairs who are incompatible or poorly matched with each other to find another donor and recipient pair or pairs with whom they can exchange kidneys to allow a more favorable compatibility and allow a transplant take place.
All medically and psychosocially eligible donor and recipient pairs are able to participate in the PKE program. Although pairs will usually participate because the donor and the recipient are incompatible because of blood type or tissue type, the program is not limited to incompatible pairs. Compatible pairs may participate and are encouraged to consider PKE as well. While compatible pairs are not disadvantaged in PKE they may benefit from paired kidney exchange by identifying a younger or better matched donor. Importantly, compatible pair participation in the paired kidney exchange pool allows other incompatible pairs to be transplanted who may not otherwise receive a kidney transplant.
What happens when you enter the Paired Kidney Exchange Program?
- Donor and recipient medical data is entered into the PKE database. The database allows for a computer matching program to find compatible donor and recipient pairs. The goal of the matching program is to find as many compatible pairs as possible and maximize the donation of one kidney from a living donor to allow as many kidney transplants as possible.
- In order to find a compatible kidney, the PKE database requires your name (Georgetown will make up an alias for the donor and recipient to protect your identities), age, blood type, tissue type, avoidable tissue (HLA) antigens for the recipient, kidney function labs, serologies and donor anatomy.
- The exchange match program runs routinely. The goal of the PKE program is to find the best outcome for all pairs involved.
- If a potential exchange pair is found, the match will be reviewed by the transplant surgeon, transplant nephrologist, and program staff. If the match is favorable, a crossmatch will be performed to confirm compatibility. A crossmatch is the mixing of blood between the donor and recipient to find out if they are compatible. Transplant centers will exchange donor charts to review records and confirm the donor is an appropriate for the potential recipient.
- Further donor evaluation or testing may be requested by the recipient center. Once all centers accept the donor/recipient matches and the crossmatches are acceptable, the transplants can be scheduled. The donor and recipient surgeries are usually scheduled on the same day.
- Donor and recipients will remain in the databases as long as each pair is medically and psychosocially acceptable and willing to participate.
- Yearly evaluation updates are required to maintain your active status in the database.
When would the donor and recipient surgeries not happen on the same day?
- If the number of pairs in the swap is very large it might be necessary to schedule the surgeries over multiple days. The surgeries may happen out of sequence which means the donor surgery can happen before the recipient surgery.
- The swap involves a non-directed donor (a person willing to donate a kidney, who does not have an intended recipient) who often begins a kidney swap chain. When kidney exchanges involve a non-directed donor (NDD), the swap becomes an open-ended chain, which often results in an end-of-chain donor without an immediately paired recipient. This donor is referred to as a bridge donor and will be informed of this prior to the beginning of the transplant chain. A bridge donor will then begin a new chain and the surgery can happen a few days to a few weeks later. Although you may withdraw from the program at any time, we do strongly urge bridge donors fulfill their commitment to the program and start a chain at a future date.
Advanced Donation Program
Donors and recipients participate in the Advanced Donation Program (ADP). There are four types of ADP cases:
- Short-term cases, where the intended recipient is on dialysis or is in need of a kidney transplant soon
- Short-Term Swap Saver, where the paired donor proceeds with donation to keep the rest of a chain swap on schedule but the recipient remains in need of a kidney transplant now
- Voucher cases, where the intended recipient is currently not in need of a kidney transplant or may not need one for a long time or ever
- Voucher Swap Save, where the paired donor proceeds with donation to keep the rest of a swap on schedule after their intended recipient is transplanted by a different donor or received a deceased donor transplant resulting in the patient no longer being in current need of a kidney transplant
Remote donation allows someone who wants to donate a kidney to a friend or family member in a distant center without requiring the donor to travel to the recipient’s transplant center. Remote donation uses logistics pioneered by the NKR to safely transport kidneys from the donor’s local hospital to the recipient’s transplant center.
In living donor liver transplantation, a piece of liver is removed from a living donor and transplanted into a recipient.
The liver's unique ability to regenerate itself combined with the expertise of our physicians and staff allow for more people with liver failure to obtain a liver transplant.
If you donate part of your liver through the MedStar Georgetown University Hospital's Liver Transplant Program, both the transplanted piece and the piece that remains will grow to pre-surgery size. The donor liver typically regenerates to its original size in 30 days, on average.
The number of patients waiting for organ transplants far exceed the number of organs donated, which has significantly increased awareness about living donor transplantation.
Living Liver Donor Transplants Save Lives
With more than 14,000 people on the waiting list for a liver transplant in the U.S. and a shortage of donated organs, the wait can be long. Unfortunately, this means that 25 to 30% of patients on the waitlist never receive the transplant they need because they become too sick for transplant or die.
Living liver donation is a life-saving alternative. With living donation, patients can receive the liver transplant they need much more quickly. A living liver donor transplant has many advantages:
- Quicker access to a transplant, before patients become too sick
- Healthier recipients have a lower risk of complications during and after transplant surgery
- Great option for patients with lower MELD scores or liver cancer who will most likely remain on the waitlist for a long time
- Higher quality of liver from living donors who undergo extensive testing
- Surgery can be scheduled when the recipient is healthiest and when it’s convenient for the donor
How Living Liver Donation Works
Unlike other organs, the liver can regrow over time. In a living liver donor transplant, a portion of the donor’s liver is surgically removed. The recipient’s entire liver is removed and replaced with the healthy donated portion, which grows to nearly full size over time. The donor’s liver also regrows to close to its original size in about eight weeks.
Who Can Be a Living Liver Donor?
In most cases, the donor is a person close to recipient, like a family member or friend, but anyone who meets the following criteria can donate. Living liver donors must:
- Be in overall good health mentally and physically and undergo a thorough medical and psychosocial evaluation
- Have a blood type compatible with the recipient’s
- Be at least 18 years old and up to age 56
- Be a healthy body weight
- Understand the risks and benefits of donation and the alternative treatments available to the recipient
- Donate voluntarily, free of coercion
- Not gain financially from donating (Paying someone to donate is illegal.)
Why Choose MedStar Georgetown Transplant Institute for Your Living Donor Liver Transplant?
- Outstanding outcomes: Our liver transplant outcomes are the highest in the region and we are a top six center in the U.S. in outcomes.
- Unmatched experience: As one of the largest transplant centers in the region, our team of transplant specialists has more than 40 years of collective experience and leads the field in the development and use of new surgical techniques and research on liver disease, treatment, and transplantation.
- Multidisciplinary team approach: We provide patient and family-centered care and support delivered by a multi-disciplinary team of physicians, nurses, pharmacists, social workers, financial counselors, and nutritionists.
- Commitment to donor safety: We ensure each donor’s safety and privacy and provide support throughout the entire donation process.
- Convenient satellite locations: We have offices throughout the region where you can undergo testing and receive follow-up care after surgery closer to home.
Become a Living Liver Donor and Save a Life
At the age of two, Nusayba was diagnosed with Stage 4 liver cancer, received two months of intense chemotherapy, and was then approved for a liver transplant. Nusayba's parents, Wajahat and Sarah, used Twitter and Facebook to share that they urgently needed a liver donor to save their daughter’s life. And people—strangers—lined up to be living donors for Nusayba. Read Nusayba's Story.
There are five steps in the process of becoming a living donor:
- Complete an online donor questionnaire, which includes information about your blood type and other health information. The team will review the information and gather your full medical history.
- If you are healthy and meet the donor criteria, you will schedule your evaluation.
- You’ll meet with the living donor team, including the surgeon, hepatologist, anesthesiologist, social worker, independent living donor advocate, and transplant coordinator.
- As part of the evaluation, you’ll undergo medical tests, including lab work to check your liver and kidney function, blood clotting factors, exposure to diseases, and autoimmune markers; an MRI and CT scan to look at the vessels and structure of your liver; and an echocardiogram (ultrasound of your heart) and electrocardiogram (ECG). The living donor team will review all your information and let you know if you are approved to donate.
- If you are approved, the final step is to schedule your donor surgery.
What to Expect During Surgery and Recovery
After being approved as a donor, the next step is the donation surgery.
- You will receive general anesthesia.
- You and the recipient will have surgery at the same time.
- Once a piece of your liver is removed, it will be transplanted immediately into the recipient.
- The surgery usually takes between three and five hours.
- You will go to the ICU for the first night to be monitored closely. You will have IVs, a Foley catheter, and a drain at your surgical site.
- You will be in the hospital four to seven days after surgery. If you have any complications, you might need to stay in the hospital longer.
Liver donation is a major abdominal surgery. The team will work to keep your pain levels down after surgery, and most donors are pain-free within three weeks.
Most donors have follow-up appointments one week, one month, six months, one year, and two years after surgery. You can expect to return to your daily activities four weeks after your surgery and return to work in between four weeks and three months.
Kidney Transplant FAQs
Liver Transplant FAQs
Living Kidney Donors: Advanced Donation Program
Exclusive Living Kidney Donor Protections
Living Kidney Donors: Compatible Paired Exchange
Non-Directed Living Kidney Donation and the Family Voucher Program