Transplant from a living donor

Pros and cons of living donor transplants

Knowing these pros and cons of living donation can help you decide if it’s right for you. Ask the staff at your transplant center all of your questions. They can also help you meet people who have gotten a living kidney donation and people who have donated a kidney.

Medical pros

• You may get a kidney sooner than if you waited on the UNOS waitlist for a kidney from someone who has died
• Your new kidney may begin working right away
  • You’ll feel healthier and more normal
  • You’ll have more energy
• You won’t need dialysis
  • You’ll probably live longer
  • You can eat more foods
  • You’ll be able to travel, work, and do other activities you may not be able to do on dialysis

Medical cons

During surgery:

• You’ll probably have common problems from any surgery, such as:
  • Pain (mostly in the first week after surgery)
  • Scars
  • Feeling weak and tired all over your body
• You have a small chance (1 in 20, or 5% chance) of having more serious problems from the surgery, such as:
  • Problems from the anesthesia, such as feeling sick or confused, muscle aches, or hypothermia
  • Infections, most commonly a virus called CMV that can cause mild or severe illness. Colds and the flu may also be more likely. Your doctor can help you treat them with antibiotics and other medicines.
  • Bleeding or needing a blood transfusion
  • Blood clots, which block your blood vessels and can stop blood flow to your heart, brain, or lungs
• You have a very small chance of dying from the surgery (1 in 3,000, or less than 1%). This chance is similar to other surgeries that require you to go under anesthesia.

After surgery:

• You have a small chance (1 in 20, or 5% chance) of short-term bloating, which may make you eat less
• You have a small chance (about 3 in 100,000, or less than 1%) of getting a disease from your donor kidney, including infections such as HIV or hepatitis. But your transplant team runs tests to help keep you from getting a disease from your new kidney.
• You may have side effects from your medicines, such as:
  • Shaking in your hands
  • Trouble sleeping
  • Weight gain
  • Hair growth or loss
  • Feeling sick to your stomach
  • Headaches
• You may have a higher chance of certain diseases, such as:
  • Cancer (especially skin cancer, so avoid sun and always wear sunblock)
  • Diabetes
  • High blood pressure
  • High cholesterol
• If your new kidney stops working, you will go on dialysis. You may be able to get another transplant. This isn’t very common, but it does happen – in about 5-10% of people (1 in 15 people).

Talk to your doctor to find out your chance of having these health problems. Your transplant team will help you watch for and try to avoid them. Stay in close contact with your transplant team after surgery so they can help you.

Emotional and social pros

• You’ll feel better and have more energy
• You’ll be able to do more:
  • You have less limits on what you eat, though you should still eat healthy foods when possible
  • You can go wherever you choose, including work and travel
  • You’ll have more free time

Emotional and social cons

• You’ll need regular check-ups and lab work
• You may have stress and emotional problems, just like any other big surgery, such as:
  • Depression
  • Post-Traumatic Stress Disorder (PTSD)
  • Anxiety
  • Feelings of guilt
• After transplant, you may feel:
  • Overwhelmed learning about how to care for your kidney
  • Upset or angry if the donated kidney isn’t working well
  • Worried about the costs of the medicines

Your transplant social worker can help you if you have any of these problems. Stay in close contact with your transplant social worker after surgery so they can help you.

Financial pros

• No more costs for dialysis
• Medicare or your health insurance will cover most of your medical tests and the costs of surgery, but not all (80% of the cost after you’ve met your deductible). You may need another insurance plan to help cover these costs, such as a supplemental or secondary policy.
• Medicaid varies in what and how much it covers. If you have Medicaid, speak with your financial counselor about what it may cover.
• Medicare covers about 80% of the anti-rejection medicine costs for 3 years after surgery. After 3 years:
  • If you are 65 or older and have Medicare, Medicare will cover most anti-rejection medicines for as long as you have the transplant
  • If you are under 65 and getting disability benefits for medical issues other than kidney failure, you also may get these medicines covered after the 3-year period
  • If you are under 65 and not getting disability benefits or were getting them for kidney failure, you will lose Medicare coverage and need to get other coverage to pay for your medicine
• If you are a veteran of the U.S. military, you may be able to get social services from the Veterans Administration. Learn more about Veterans benefits
• You may feel well enough to work

Financial cons

Medical costs:

• Insurance deductibles and co-pays
• Medical bills for health care professionals and procedures, such as:
  • Pre-transplant interviews and testing
  • Fees for getting the organ from the donor
  • Surgery
  • Follow-up care and testing
  • Doctors, such as surgeons, physicians, radiologist, and anesthesiologist
  • Lab tests
  • Hospital stays for any problems
• Medicine costs, which can be more than $2,500 per month if you don’t have insurance
• Rehabilitation costs

Non-medical costs:

• Food, lodging, and long distance phone calls for you and your family if the center is far from your home (some centers offer free or low-cost housing for you and your family)
• Transportation to and from your transplant center, before and after your transplant
• Child care
• Lost wages (if not covered by your employer)
• Problems getting life insurance or affording health insurance. Talk to your transplant social worker or financial counselor if you’re worried about affording insurance.

It’s normal to feel worried about the costs, but your transplant financial coordinator or social worker can help you plan for insurance and any costs for transplant. This will help you take care of your finances so you can focus on getting healthy. Stay in close contact with your transplant team before and after surgery so they can help you.