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Kidney Donation: How It Works and Who Can Participate

Every year, thousands of people across the United States wait for a lifesaving kidney transplant.

For those living with end-stage kidney disease, a transplant can offer a second chance at life—restoring health, energy, and freedom from dialysis. Kidney donation plays a critical role in meeting this demand, and many generous individuals choose to give the gift of life by becoming donors.

This guide explains how kidney donation works, who can donate, and what the process looks like for both living and deceased donors.

Why Kidney Donation Is Important

Kidney disease affects over 37 million Americans. When kidneys can no longer filter waste and fluids effectively, patients must either go on dialysis or receive a transplant. Unfortunately, the demand for kidneys far exceeds supply.

  • Over 90,000 people are currently on the kidney transplant waiting list in the U.S.
  • Many patients wait 3 to 5 years or longer.
  • Living donation helps reduce this wait time and improves transplant success rates.

Types of Kidney Donation

1. Living Donation

Living donors voluntarily donate one of their two healthy kidneys. Because people can live with one kidney, living donation is a safe and effective way to save a life.

Key points:

  • The remaining kidney grows slightly and takes over full function.
  • Living donor transplants typically last longer than deceased donor transplants.
  • Donors can be family members, friends, co-workers, or altruistic strangers.

2. Deceased Donation

When someone dies (often from a brain injury), they can donate their kidneys if they were previously registered as organ donors or if their family consents.

Key points:

  • Organs must be removed quickly and preserved properly.
  • A single deceased donor can save up to eight lives.

Who Can Be a Kidney Donor?

Living Donor Eligibility

To donate a kidney, a person must typically:

  • Be 18 years or older
  • Be in good physical and mental health
  • Have normal kidney function
  • Be free of chronic conditions like diabetes, uncontrolled high blood pressure, or active cancer
  • Undergo a comprehensive medical and psychological evaluation

Each transplant center has its own criteria. Some people with certain medical histories may still be considered on a case-by-case basis.

Deceased Donor Eligibility

Most people can be organ donors at the time of death, regardless of age or medical history. Organ procurement organizations evaluate potential donors individually to determine eligibility.

The Living Donation Process: Step by Step

  1. Initial Screening
  2. Potential donors complete a health questionnaire and talk to a transplant coordinator.
  3. Medical Evaluation
  4. Includes blood tests, imaging, urine samples, heart/lung screenings, and a psychosocial assessment.
  5. Matching
  6. Donors must be blood and tissue compatible with the recipient. If not, they may participate in paired kidney exchange programs.
  7. Approval and Surgery
  8. If approved, the donor and recipient schedule surgery. The procedure is often done laparoscopically, with a shorter recovery time.
  9. Recovery
  10. Most donors spend 1–3 nights in the hospital and return to work in 4–6 weeks. Long-term follow-up is essential.

Risks and Benefits of Living Donation

Benefits

  • Save or dramatically improve another person’s life
  • Psychological satisfaction and a sense of purpose
  • Typically short hospital stay and full return to normal life

Risks

  • Surgical complications (though rare)
  • Temporary pain or fatigue
  • Emotional adjustment during recovery
  • Slight increase in long-term risk for kidney disease (carefully monitored)

All living donors receive extensive counseling and are given time to make an informed, voluntary decision.

How to Register as a Deceased Donor

  • Sign up at your state’s organ donor registry (typically done through the DMV)
  • Indicate your decision on your driver’s license
  • Tell your family about your wishes

Being a registered donor ensures that your organs may be used to save others in the event of your death.

Ethical and Financial Considerations

  • It is illegal to buy or sell organs in the U.S.
  • Donors do not pay for transplant-related medical costs—these are covered by the recipient’s insurance.
  • Some programs offer reimbursement for travel, lodging, and lost wages.

Final Thoughts

Kidney donation is an extraordinary act of generosity. Whether you’re considering donating a kidney to someone you know or registering to become a deceased donor, your decision can have a life-changing impact.

If you’re interested in learning more, talk to a transplant center, visit organdonor.gov, or explore living donation programs in your area.

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