Medical implications

What are the risks of kidney donation?

Even though kidney donation by a living person has proven to be a very low-risk act, it is not completely risk-free. The dangers from kidney donation fall into two categories:

  1. Short-term – The operation itself
  2. Long-term – Life with one kidney

The operation

Any operation, even minor surgery such as cosmetic surgery, involves pain, difficulties, and risks. The main risks are anaesthesia, bleeding, and infections. In kidney donation surgery theses risks are not great, especially operations which are performed laparoscopically (minimally invasive) which are less exposed to infection.  Furthermore, advanced anaesthetic methods have reduced the risks of anaesthesia, and innovative surgical techniques, along with recently-developed drugs, offer reasonable responses to the dangers of bleeding.  In the medical literature, estimates of the risk of kidney-donation surgery are put at 1 in 3,000. This is considered a negligible level of risk.

In summary: The risk of surgery is low, even very low, but still present, and must be taken into consideration before making a decision to donate. When kidney donors are asked about the risks, many respond that we all routinely take actions in our lives which involve risk. The risk of giving birth, for example, is similar to that of kidney donation, and the risk of birth by C-Section is several times higher.

Remaining with one kidney    

A question which is lodged in the mind of anyone interested in donating his kidney: What if I need the kidney which I donated? The chances that a kidney donor will require a kidney transplant are tiny, for a few reasons:

  1. Anyone who has been approved as a donor has undergone comprehensive testing which assures that his health is sound and that he is not a member of any group with a high risk of developing renal disease.
  2. In other words, even if someone has only one kidney, he will be affected the same as a person with two kidneys. For example, if a person gets diabetes, or hypertension, or a virus, or some defective medication, his having two kidneys will not save him. If he has one kidney, it will be affected and if he has two kidneys, they will both be affected. So donating a kidney does not increase the risk very much at all. The danger is aroused in case of an accident, God forbid, which physically damages the kidney, or a growth which develops in the kidney. In that case having a second kidney would prevent needing a transplant. However those are extremely rare events.
  3. In Israel, the United States and in other countries there is a law that an organ donor who himself needs a transplant goes to the top of the national list of recipients, which serves as a type of “insurance policy” in case he loses his own organ. (The law in Israel also includes first-degree relatives of the donor.)

Scientific Articles

  • In January of 2009, The New England Journal of Medicine printed an article detailing a comprehensive research study that examined thousands of kidney donors from the last few decades and found indisputable evidence that the health of kidney donors was not harmed in the slightest!  Research has proven that kidney donation does not change the donor’s life expectancy nor does it increase the risk of developing kidney disease or other health problems. A person can live a normal, active life with one kidney. Research has indicated that one kidney is sufficient to maintain a healthy body. After recovery from the operation, a donor can work, drive, exercise and take part in sports, and continue with his usual activities, including military service.  Read the full article.
  • In February 2016, The New England Journal of Medicine printed an article detailing a comprehensive research study that compared a group of kidney donors to a group of very healthy people. The results of the study showed that kidney donors were less healthy than the group of very healthy people. Read the article in the New England Journal of Medicine
  • These two articles represent two different schools of thought.  In order to analyze the results and in order to help one make a decision, we asked Dr. Keren Tzukert, a specialist in nephrology, at Hadassah Medical Center, Ein Kerem, Jerusalem to  explain to the lay person the implications and considerations. (The original article was written in Hebrew)..

Can a kidney donor become pregnant?

Yes, kidney donors can become pregnant and have children.  See the articles Pregnancy and Birth After Kidney Donation: The Norwegian Experience and Pregnancy Outcomes After Kidney Donation.  Both of these articles are from the American Journal of Transplantation.