Understanding the risks
Donating a kidney is generally a safe operation, but like any major medical procedure, it comes with risks — both short-term (surgical) and long-term (health-related). It’s important to understand these fully when considering living donation.
We’ve set out the short, medium and long-term risks below, but you should always discuss any risks you might have with your doctor as everyone is different.
Anaesthetic
Complications due to anaesthetic issues are rare, particularly in people who are live donors as they have had a thorough work-up. If there are concerns an anaesthetic consultant will see you well in advance of the surgery.
The Operation - bleeding
The kidneys sit beside the major blood vessels and organs such as the colon, pancreas, lungs and spleen and there is the potential for damage during removal of the kidney. There’s also a small possibility of bleeding occurring but this can generally be seen to at the time by the surgeon.
Spleen
Very rarely, but occasionally, the donor may need a blood transfusion or go back to theatre. Moving the spleen to reach the kidney can lead to bleeding which may require removal of the spleen (splenectomy). Splenectomy weakens the immune system, in the unlikely event that this happens you may need antibiotics.
Gut/bowel
Moving the bowel to reach the kidney very rarely causes damage. However sometimes this is not obvious until after the operation, and may require further surgery.
In exceptional circumstances this may mean creating a temporary colostomy (bag on wall of abdomen) for a few months to rest the bowel until it can be safely repaired.
Lung
The pleura (the space around the lung) may be inadvertently be opened during surgery. If this happens, the lung may collapse. The surgeon would need to insert a tube into the chest to allow recovery.
Short-term risks
These are the risks that could occur around the time of the operation and shortly afterwards.
These risks are mentioned because they are serious, but they are exceptionally rare.
Living donation is generally considered a low-risk procedure with death occurring to be around 3 per 10,000. This is comparable to the risk of dying with having surgery to remove an appendix.
Pain
Some donors have persistent discomfort and experience medium to high level pain.
Irritable bowel symptoms
It is common for the bowel to take a day or two to work after the operation.
Occasionally donors notice that their bowel habit have not returned back to normal with ongoing subtle change toward constipation and/or diarrhoea. There may be medications and dietary alterations which will help.
Hernia
A bulging of the tummy may occur where there has been a cut into the abdominal wall muscle. This may complicate any surgery in this area.
Testicular discomfort
Some men who have donated will experience discomfort in the testicle on the side where the kidney has been removed. This can happen as the vein from the testicle joins the vein from the kidney that has been removed.
This means a little more blood than usual accumulates in the testicle, and this can be uncomfortable for the first month or two following surgery.
This discomfort settles with time.
Medium-term risks
Medium-term means in the first few months the following can be a problem, but remember, only a very small number of donors have any issues in this period.
Considerations
Anything else that will affect one kidney in general, will affect both kidneys.
However, in the unlikely event that you develop a problem with your kidney you would be seen immediately by the renal team
Future test results
Your kidney blood tests may not be the same after donating a kidney, however, as long as the results are stable, there’s no protein leak in the urine, and your blood pressure is good, there is no cause for concern.Â
After you have donated, it’s recommend that you have your blood pressure, urine and kidney blood tests, checked once a year. This can be organised by the hospital team, or with your local GP.
Having one kidney
If your remaining kidney was affected by trauma or cancer or any other illness, you would have priority on the transplant list .
Long-term risks & Considerations
Long-term risks happen several years after donation.
Donating a kidney doesn’t mean you won’t experience other medical problems. There is a link between blood pressure and kidney failure, so if you have one kidney, it’s important to have normal blood pressure readings.
Psychological risks
There are huge benefits of living kidney donation for recipients and donors. It can be a rewarding and positive experience for those who see a close friend or family member live a fuller and healthier life.
However, although most living donor transplants work very well, sometimes they doesn’t always go as planned.
If you donated a kidney and it failed, or only functioned for a short time, it can be very difficult to cope with the situation. It’s important for anyone considering donating to consider this possibility in advance. Renal psychological support is available at most transplant centres.