A living-donor transplant is a surgical procedure to remove an organ or portion of an organ from a living person and place it in another person whose organ is no longer functioning properly.

The popularity of living-organ donation has increased dramatically in recent years as an alternative to deceased-organ donation due to the growing need for organs for transplantation and shortage of available deceased-donor organs. About 6,000 living-organ donations are reported each year in the U.S.

People can donate one of their two kidneys, and the remaining kidney is able to perform the necessary functions. Living-kidney donation is the most common type of living-donor procedure.

Living donors can also donate a portion of their liver and the remaining liver regenerates, grows back to nearly its original size, and performs its normal function.

Kidney and liver are the most common types of living-donor organ procedures, but living people may also donate tissues for transplantation, such as blood, skin and bone marrow.

Health History Questionnaire

Interested in being a living kidney or liver donor? Start the process by completing a Health History Questionnaire.

Living-organ donation types

There are two types of living-organ donation.

Directed donation

This is the most common type of living-donor organ donation. In this type of living-organ donation, the donor is directing the organ to a specific recipient for transplant.

The recipient may be:

  • A first-degree relative, such as a parent, brother, sister or adult child
  • A biologically unrelated person who has a connection with the transplant candidate, such as a spouse or significant other, a friend, or a coworker
  • A person who has heard about the transplant candidate's need

Nondirected donation

In nondirected donation, also known as good Samaritan or altruistic donation, the donor does not name the recipient of the donated organ. The match is based on medical need and compatibility.

In some cases, the donor may choose not to know the recipient. In other cases, they may meet if both the donor and recipient agree and the transplant center policy allows it.

Paired donation and donation chains

Living donors often play an important role in paired donation and donation chains. Paired-organ donation (also known as paired exchange) may be an option when a donor and intended recipient have incompatible blood types, or when the recipient has unacceptable antibodies against the donor's tissue antigens.

In paired donation, two or more organ-recipient pairs trade donors so that each recipient gets an organ that is compatible with his or her blood type. A nondirected living donor also may participate in paired-organ donation to help match incompatible pairs.

More than one pair of incompatible living donors and recipients may be linked with a nondirected living donor to form a donation chain in order to receive compatible organs. In this scenario, multiple recipients benefit from a single nondirected living donor.

Mayo Clinic's approach

June 24, 2016
  1. Living donation: Information you need to know. Transplant Living. https://www.unos.org/donation/living-donation/. Accessed March 30, 2016.
  2. Cotler SJ. Living donor liver transplantation. http://www.uptodate.com/home. Accessed March 31, 2016.
  3. U.S. Department of Health and Human Resources. Organ and Tissue Donation from Living Donors. Accessed March 30, 2016. http://www.organdonor.gov/about/livedonation.html.
  4. Qualifications. Transplant Living. http://www.transplantliving.org/living-donation/being-a-living-donor/qualifications/. Accessed April 1, 2016.
  5. Risks. Transplant Living. http://www.transplantliving.org/living-donation/being-a-living-donor/risks/. Accessed March 30, 2016.
  6. Lentine KL, et al. Evaluation of the living kidney donor. http://www.uptodate.com/home. Accessed April 5, 2016.
  7. Liver. Transplant Living. http://www.transplantliving.org/living-donation/about-the-operation/liver/. Accessed April 5, 2016.
  8. Barbara Woodward Lips Patient Education Center. Living kidney donor transplant. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
  9. Barbara Woodward Lips Patient Education Center. Donating part of your liver for a transplant: Information for living donors. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
  10. Kidney. Transplant Living. http://www.transplantliving.org/living-donation/about-the-operation/kidney/. Accessed April 5, 2016.
  11. Making the decision. Transplant Living. http://www.transplantliving.org/living-donation/being-a-living-donor/making-the-decision/. Accessed April 5, 2016.
  12. Costs. Transplant Living. http://www.transplantliving.org/living-donation/financing-living-donation/costs/. Accessed April 1, 2016.
  13. Insurance. Transplant Living. http://www.transplantliving.org/living-donation/financing-living-donation/insurance/. Accessed April 1, 2016.
  14. Vella J. Living unrelated donors in renal transplantation. http://www.uptodate.com/home. Accessed March 26, 2013.
  15. Pregnancy. Transplant living. http://www.transplantliving.org/living-donation/being-a-living-donor/pregnancy/. Accessed April 6, 2016.
  16. OPTN kidney paired donation pilot program. Transplant Living. http://www.transplantliving.org/living-donation/types/paired-donation/. Accessed April 5, 2016.
  17. Müller SA, et al. Partial liver transplantation-living donor liver transplantation and split liver transplantation. Nephrology Dialysis Transplantation. 2007;22(suppl):viii13.
  18. Eligibility guidelines. Arlington, Va.: National Living Donor Assistance Center. http://www.livingdonorassistance.org/potentialdonors/eligibilityguidelines.aspx. Accessed April 5, 2016.
  19. Lentine KL, et al. Risks of live kidney donation. http://www.uptodate.com/home. Accessed April 1, 2016.
  20. Selecting a hospital. Transplant Living. http://www.transplantliving.org/before-the-transplant/getting-on-the-list/selecting-a-hospital/. Accessed April 5, 2016.
  21. Hays RE, et al. The independent living donor advocate: A guidance document from the American Society of Transplantation's Living Donor Community of Practice (AST LDCOP). American Journal of Transplantation. 2015;15:1447.
  22. Shapiro R, et al. Benefits and complications of laparoscopic donor nephrectomy. http://www.uptodate.com/home. Accessed April 5, 2016.
  23. National Kidney Foundation. What to expect after donation. https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation. Accessed April 6, 2016.
  24. Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. April 6, 2016.
  25. Scientific Registry of Transplant Recipients. Living kidney transplants, July 1, 2014-June 30, 2015. http://www.srtr.org/csr/current/Centers/TransplantCenters.aspx?organcode=KI. Accessed April 6, 2016.
  26. Taner T (expert opinion). Mayo Clinic, Rochester, Minn. April 7, 2016.