Definition

Mayo Clinic surgeons have experience performing living-donor transplant surgery for liver transplant and kidney transplant. Read more about living-donor transplantation.

  • Experience. Mayo Clinic transplant doctors, surgeons and other transplant staff members at Mayo Clinic in Arizona, Florida and Minnesota have extensive experience with living-donor transplantation. Mayo Clinic has one of the largest transplant practices in the United States.

    The majority of kidney transplants at Mayo Clinic in Minnesota are done using organs from living donors.

  • Team approach. Mayo Clinic's integrated teams of surgeons, doctors, transplant nurses, pharmacists and others work together to provide your care from your evaluation through post-surgery care.
  • Treatment expertise. Mayo Clinic doctors and surgeons have expertise with all types of living-donor transplant surgeries, including ABO incompatible transplant, positive crossmatch transplant, paired donation and other complex procedures.
  • Innovation. Results of transplantation, particularly with living donors, are generally very good, but they can be improved. Staff in Mayo Clinic's transplant programs has taken a leading role in efforts to find new, improved ways to conduct aspects of transplantation, improve the experience of donation, reduce risks and improve the outcomes of transplantation.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

About

Mayo Clinic transplant doctors, surgeons and other transplant staff members have extensive experience with living donation for kidney and liver transplants.

Mayo Clinic surgeons perform living-donor transplant surgery for liver transplant and kidney transplant. In addition to donating living organs, you also may donate bone marrow for a bone marrow transplant.

Living kidney donation has been used in transplantation for more than 50 years. Many studies have shown that kidney donation is safe in the short and long term after surgery.

However, you'll need to have surgery to donate a kidney, and you'll then be exposed to some risks. To minimize risks, you'll need to have extensive testing to ensure you're eligible to donate a kidney. Living kidney donors are generally not at an increased risk of kidney failure in the future.

The risks of living liver donation are also low, but experience with this procedure is more limited because it was introduced into medical practice more recently than was kidney donation. Living liver donation may involve risks such as surgical complications or acute liver failure. Deaths after donation have occurred rarely.

Researchers actively study the health of donors after transplant surgery to improve results. Read more about liver transplant outcomes and kidney transplant outcomes.

Donor evaluation

A multidisciplinary transplant team will evaluate you to determine if you're a candidate to be a living donor. Different transplant team members will perform evaluations and surgeries for you and your recipient.

During an evaluation, your transplant team has several goals. The team will evaluate your general physical and mental health to make sure that undergoing living-donor surgery offers few risks for you.

Also, during the evaluation the team will check to ensure that the organ you're planning to donate is healthy and that removing either one of your kidneys or a portion of your liver is unlikely to cause health problems later in life.

You'll have blood tests to determine if your blood and tissue types are compatible with the organ recipient.

Transplant staff will interview you, and you'll need to provide your medical history. You'll also have a thorough physical examination and psychological evaluation. Your evaluation is confidential.

Doctors will perform tests to look for pre-existing conditions that may disqualify you from being a donor, such as diabetes, cancer, some infectious diseases, heart diseases or other conditions.

Several other tests, including detailed imaging of your liver or kidneys, will be performed to ensure that you're in good health and you meet donation criteria. If you're a potential liver donor, doctors will review your imaging tests to determine if the size of your liver is the appropriate size for the recipient.

Transplant staff will discuss with you and your family the benefits and risks of donating a kidney or a portion of your liver and answer your questions. Staff will also discuss the importance of maintaining a healthy lifestyle before and after donating an organ.

Donation risks

Donating an organ is a gift that can improve the quality of life or possibly save the life of the organ recipient. However, you also should consider the potential risks of donating an organ, such as surgical complications, organ failure and psychological problems.

If you're a liver donor, you should consider the potential risks of surgical complications in living liver donation surgery. Liver transplant surgery is a complex surgery that involves risks of surgical complications for the recipient, and it isn't always successful.

If possible, bring a family member or friend with you for your evaluation and surgery. It may be helpful for you to discuss your decision to donate with a family member or friend.

If you're committed to donating an organ, your transplant team will partner with you and your local health care provider throughout the living-donor transplantation process. Your team will also be available to answer any questions you have about the donation process.

Living donation is a complicated process. Transplant staff understands and expects you to have many questions. Doctors and other staff are available to answer your questions.

Surgery

  • Living kidney donation. Surgeons generally perform minimally invasive surgery to remove a living-donor's kidney (laparoscopic nephrectomy) for a kidney transplant, which involves less pain and a shorter recovery. Mayo Clinic surgeons have extensive experience performing laparoscopic nephrectomies.

    After you donate a kidney, you'll generally spend two or three days in the hospital recovering and be able to return to daily activities after two to four weeks.
  • Living liver donation. For living liver donation, surgeons remove a portion of your liver through an incision in the side of your abdomen. Read more about living-donor liver transplant. After you donate part of your liver, you'll spend about a week in the hospital recovering, and you may return to daily activities after two to three months.

After your surgery

  • Care after your surgery. If you live several hours away from Mayo Clinic, doctors recommend that you stay near Mayo Clinic for a few days after you leave the hospital so that they can monitor your health.
  • Follow-up care. Your transplant team will coordinate your follow-up care with your local primary health care provider.

    After you donate, living-donor coordinators and other transplant staff members will offer you support and follow-up care for several months after your surgery. Transplant staff is committed to your care after you donate an organ.

    If you've donated a kidney, your transplant team will coordinate your follow-up care after your surgery.

    Your doctors will require you to come to follow-up appointments at Mayo Clinic six months after your surgery for blood tests, kidney function tests and blood pressure monitoring. You'll need to have laboratory tests to check your kidney function one year and two years after your surgery.

    If you've donated part of a liver, doctors will perform an ultrasound of your liver about a week after your surgery. You'll have laboratory tests every two weeks, two or three times, so doctors can determine when your liver function has returned to normal.

    You'll also need to have laboratory tests six months, one year and two years after your surgery to test your liver function.

    Your local health care provider may conduct your laboratory tests one and two years after your kidney or liver surgery. Mayo staff will notify you about which tests you'll need. If you have tests near home, you'll need to send the laboratory test results to Mayo Clinic.
  • Lifestyle after your surgery. It's important to continue to stay healthy and keep a healthy lifestyle.

Read more about a healthy diet, fitness, high blood pressure (hypertension) and the BMI calculator.

Types

Mayo Clinic surgeons perform living-donor transplant surgery for liver transplant and kidney transplant.

Generally, your blood and tissue types need to be compatible with the organ recipient. If you're donating part of a liver, you'll need to have the appropriate size liver for the recipient.

However, if you're a kidney donor and your blood and tissue types aren't compatible with the recipient, then other types of living-donor kidney transplants may be available in some cases. Mayo Clinic transplant programs offer:

  • Blood type (ABO) incompatible kidney transplants. In an ABO incompatible kidney transplant, your blood type isn't compatible with the recipient's blood type.
  • Paired donation. In paired kidney donation, donors and their recipients may not be compatible, or recipients may benefit from a kidney that is a different size or age from the original donor. Or, donors and their recipients may be compatible, but they wish to participate in paired kidney donation.

    If another donor and recipient pair is also incompatible, exchanging donors may allow both recipients to have transplants with kidneys that match their needs.

  • Positive crossmatch kidney transplants. In a positive crossmatch kidney transplant, you're not compatible with the recipient because the recipient has high levels of antibodies in his or her blood that react against your cells.

    Mayo Clinic researchers have developed protocols that may make this procedure possible under certain circumstances.

  • Nondirected (anonymous) kidney donation. In a nondirected (anonymous) kidney donation, you have no intended recipient, but you're offering the kidney as a gift to be used for the most appropriate recipient, who will be selected by the transplant center.

    You'll be evaluated to determine if you fit the criteria to be an organ donor. You'll also have a mental and social (psychosocial) evaluation to evaluate your motivation for donating an organ and your support system.

    If it's determined you fit the criteria to be an organ donor, your kidney will be given to a recipient who may best benefit from a kidney.

Candidates

In order to be eligible to donate an organ, you must fit several criteria, including:

  • Be at least 18 years old to donate a kidney, and generally be between ages 21 and 55 to donate part of a liver.
  • Be in good physical and mental health.
  • Have desire to be tested for compatibility and willingness to donate.
  • Have blood and tissue type compatibility with the recipient. If you're incompatible with the recipient you may choose to participate in the paired kidney donation program.
  • Be informed of the benefits and risks of being a donor.
  • Be able to give informed consent to begin a screening and to become a donor.
  • Have support from family members and friends regarding becoming a donor.
  • Have no current alcohol or recreational drug abuse problems.
  • Have no active chronic conditions, such as cancer, diabetes or infectious diseases, that would make you ineligible to donate an organ.

FAQ

Living-donor frequently asked questions

What services will the recipient's insurance cover?

All medical services related to organ or tissue donation are submitted to the recipient's insurance. Your recipient's insurance typically will cover all medical services related to your organ donation, including your evaluation, hospitalization, surgery, follow-up care and treatment of any surgical complications.

What services could be billed to my insurance?

If you have medical services that aren't considered part of the standard donor evaluation, or if you receive further tests or treatment for any condition found during the evaluation, a claim will be submitted to your insurance.

You'll be responsible for paying for any tests or treatments that aren't related to a standard donor evaluation or treatment. Staff will recommend that you obtain insurance prior to evaluation and surgery if you don't currently have insurance.

What if I don't have insurance?

Services that aren't considered part of the standard donor evaluation or treatment of any condition found during the evaluation require a pre-service deposit. These arrangements can be made at any one of the business office locations.

For more information about billing and insurance, including information about charitable care, see billing and insurance for Mayo Clinic in Minnesota, Arizona and Florida.

What if my insurance doesn't cover me at Mayo Clinic?

Services directly related to your living-donor evaluation will be billed to the recipient's insurance. For nontransplant-related services, check with your medical team to determine if services can be performed by your local health care provider. You can also choose to pay for the services out-of-pocket. You'll be responsible for paying for any nontransplant-related services.

How will being a living donor affect my current insurance or getting new or additional insurance?

Please contact your insurance provider or your employer's human resources representative for your specific plan information.

Is there any assistance available as a donor for my travel and lodging expenses?

You'll be responsible for your travel and lodging during your evaluation and before and after your surgery. It's important to discuss with the recipient whether his or her insurance plan will cover travel, lodging, child care and other expenses for you as a living donor.

If the recipient's insurance plan doesn't cover these costs, ask the recipient if he or she will be reimbursing your travel and lodging expenses. It's illegal to be paid to be a donor. However, you can request that the recipient reimburse your travel, lodging, child care and other transplant-related expenses.

If you aren't being reimbursed for your travel expenses by the recipient or by any other method, you may apply to the National Living Donor Assistance Center for reimbursement. If you meet specific eligibility criteria, the National Living Donor Assistance Center may reimburse some of your travel costs.

What donor information is released to the recipient's insurance?

Your recipient's case manager will be notified regarding your medical approval as a living donor. In Mayo Clinic correspondence, your identity as a donor is kept anonymous.

 

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

800-446-2279 (toll-free)
8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday

Email

ARZTransplantCtr@mayo.edu

904-953-0853
8 a.m. to 5 p.m. Eastern time, Monday through Friday

Email

transplant-fla@mayo.edu

507-538-3270
7 a.m. to 6 p.m. Central time, Monday through Friday

Email

transplant-rst@mayo.edu

International

Clinical trials are research studies that test new ways to detect, prevent or treat disease. Mayo Clinic conducts more than 3,000 clinical trials and research studies each year and often coordinates national clinical trials with other medical centers.

Learn more about clinical trials and whether Mayo Clinic may be conducting a clinical trial related to your condition or procedure.

Mayo Clinic doctors actively perform research in kidney and liver transplantation, presenting their work at national and international meetings. The Mayo Clinic Transplant Center supports many studies for kidney and liver transplant research and living donation research. Read more about transplant research.

Publications

See a list of publications by Mayo Clinic doctors on living-donor transplant on PubMed, a service of the National Library of Medicine.

Read about how Mayo patients do well before and after liver transplant.

Nov. 12, 2014