How safe is donation?

If you are thinking of donating a kidney, it is important to consider your decision carefully. One of the most frequently asked questions is, “How safe is it to live with one kidney?” After all, most of us are born with two! Donor safety is a priority. Regardless of the need for kidneys, donation is not acceptable if the donor is put at excessive risk of harm, so every effort is made to minimise the chance of problems. Being a healthy person is not the same as being a suitable donor. For example, you may have been born with only one kidney and only discover this when you put yourself forward for tests. This would obviously prevent you donating a kidney, but it does not mean that you are not healthy.

Your healthcare team will discuss risks with you in much greater detail during your assessment process, and you should feel free to ask any questions about these risks. Donors should be comfortable accepting the risks before deciding to donate.

There are two aspects to the question of how safe donation is for the donor: the operation itself, and living with one kidney.

The operation

Donating a kidney requires a major operation under general anaesthetic. No operation is risk-free, so it is important to make sure that you are fit and well beforehand so that the risks to you are as low as possible. (See section entitled The donor operation). It is very difficult to describe risk in a way that means something to everyone, but we usually say that the risk of dying from donating a kidney is one person in 3,000. This is similar to the risk of dying from having an appendix removed. Compare this with the general risk of dying of ANY cause of an average 50 year old – which is estimated at 1 in 400 for males and 1 in 500 for females!

There are a number of other risks linked with the operation itself, such as infection, bleeding and pain. One of the benefits of being a kidney donor is that you go into the operation in good health, and the transplant team will know a great deal about you from the assessment that you have been through. This helps them to anticipate any problems, discuss them with you and to deal with them better should they happen. Every transplant centre in the UK performs transplantations of kidneys from living donors, and one in every three kidney transplants is from a living donor – around 1000 such operations are performed in the UK each year. This means that the donor operation is much more common than it used to be and surgeons are very experienced in removing kidneys safely.

Your medical team will discuss the risks with you as you go through the process and you will need to consider these carefully when deciding whether you wish to be a donor.

Living with one kidney

It is generally very safe to live with one kidney and your Living Donor Coordinator will outline the main risks to you.  Studies continue in this area and your Coordinator will have access to the latest research.

Some studies have indicated that there is a slightly increased chance of a small increase in your blood pressure or protein in your urine as a result of having one kidney. However, these are checked at annual follow-up and, if found, can easily be treated.

Once you have recovered from the operation itself, life should be back to normal: no change in lifestyle, diet or anything else is needed. This does not mean that you will never be ill or that you will never have a kidney problem in the future, but donation does not increase your risk of these things happening.

Risks for the recipient

How safe is living donation for the recipient of a kidney? Quite simply, living donor kidneys are the ‘Rolls-Royce’ of kidney transplants, because we know that the kidney has come from someone in the best of health, and the operation will have been planned under the best possible circumstances. There is no doubt that the potential benefit to the recipient far outweighs the risk to the donor.

Transplantation is an uncertain business, and there are no guarantees of success, but living donation has all the right ingredients to create the best opportunities for a good outcome for the recipient. It truly is the gift of life.

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