Expert care for living kidney donors and living kidney transplant recipients
The gift of a kidney can save a life. And with living kidney donation, patients can receive transplants faster and move on with the rest of their lives.
To maximize the possibility that our patients will get a living donor kidney transplant, we are active members of the largest national living donor exchange program, the National Kidney Registry.
At University of Washington Medical Center, special care is given to our kidney donors, whom we admire for their generosity. All those who wish to donate a kidney are carefully and respectfully evaluated by our team to make sure that it is safe for them to donate.
Why do patients come to UW Medicine Kidney Care for living kidney transplantation?
Better outcomes: According to the Scientific Registry of Transplant Recipients (SRTR), the UW Medical Center transplant rate is statistically significant — 57% higher than the expected rate for our patient population. This represents the highest rate of adult kidney transplantation in the Pacific Northwest.
Shorter waits: There is a shorter waiting time for living donor kidney transplantation. However, our patients being evaluated for living donor kidney transplantation are also placed on our transplant waiting list to provide additional options.
One-stop patient care: Throughout the pre- and post-transplant process, our patients often see specialists from other disciplines, such as radiology, oncology, cardiology, vascular and infectious disease. All are experienced in treating kidney dysfunction and all are here at UW Medical Center.
- And if necessary, we can also transplant other organs — the pancreas, liver or heart — at the same time we perform your kidney transplant.
Living kidney donations
Review our donor checklist for an overview of what the transplant workup process involves and explore the living kidney donation overview. If you wish to be considered for living kidney donation, please complete the potential living kidney donor screening.
When potential kidney donors are compatible with their intended recipients, they can donate directly to their recipients.
Paired kidney exchange
When potential kidney donors cannot donate to their intended recipients because of mismatched age, size, blood type, tissue incompatibility or other factors, they can enter a donor exchange program and donate to another person, which will allow their intended recipient to receive a kidney from another donor. See diagram below.
Once a donor and recipient are approved for the transplant, they join a private registry (computer program) of other people, consisting of pairs of donors and recipients who are not compatible with each other. A computer program then matches these donors and recipients to people with whom they are compatible.
Donor exchange can also be started by a non-directed donor, someone who donates anonymously without having a specific recipient. This situation starts a donor chain. See diagram below.
What registry does University of Washington Medical Center use?
Today there are several major groups organizing kidney exchanges across the United States. These kidney registries are different than the national kidney waiting list through United Network of Organ Sharing (UNOS). The national kidney waiting list is for people to receive a kidney from a donor who is deceased. Patients on the kidney exchange registries may stay active on the national kidney waiting list through their transplant center while they are also registered with a kidney exchange program.
The University of Washington Medical Center is a Member Center of the National Kidney Registry (NKR). The website for the National Kidney Registry is kidneyregistry.org.
Is there additional testing needed for donor exchange?
Living kidney donors and transplant recipients participating in the donor exchange have the same medical work up and evaluation as traditional living donation. However, there could be some additional testing required for the National Kidney Registry.
Will I have to travel for the transplant or donation?
The donor kidney may be given to someone who lives in Washington or to someone who lives in another state. If a donor matches with a recipient in another location, the kidney would be shipped from the donor’s center to the recipient’s center. Shipping the kidney should not cause any decrease in success of the transplant.
Does a donor have to give a kidney before their recipient receives a kidney?
No. Typically, the kidney donation and transplant happen within the same 24 hours. There are alternate options, which can be discussed with your providers.
How long does it take to find a match once the donor and recipient are added to the National Kidney Registry?
The average wait time is about 10 months. How quickly a match can be found for a potential recipient can depend on blood type and whether there is a high level of antibodies against human tissue already present (high panel reactive antibody [PRA]). In addition, the blood type of the possible donor can make a difference — if the donor has a more common blood type, a match can be found more quickly. The transplant center can evaluate more than one donor per recipient to be entered into the registry since this can potentially increase the speed of finding a match and allow more transplants to be done.
If you would like to participate in paired kidney exchange or have questions, please contact University of Washington Medical Center at 206.598.3627.
Non-directed kidney donation
The process of non-directed donation is for people who wish to donate a kidney but do not have a specific person selected to receive the donation.
How it works
First, the potential donor will undergo an extensive medical and psychological evaluation to determine that he or she is a suitable candidate. If the person is approved to donate, his or her kidney would then be given anonymously to someone in need of a kidney transplant.
Non-directed donors may donate to an adult through the University of Washington Medical Center transplant list, a child through the Seattle Children’s Hospital transplant list, or to a recipient through the National Kidney Registry. A non-directed donor can start a chain of transplant.
Risks and rewards
Living donation can improve the quality of life of the kidney recipient and be a highly rewarding experience for the living donor. However, there are risks involved, and it is important to think carefully about the physical, emotional and financial impact of donation.
If you have any questions about non-directed donation or are interested in becoming a non-directed donor, please contact our Living Donor Advocate at 206.598.3627.
What is paired kidney donation?
When potential kidney donors cannot donate to their intended recipient because of a mismatched blood type or tissue incompatibility, they can participate in a donor exchange program and donate to another person. This option allows the intended recipient to receive a kidney from another donor.
The evaluation for being a living kidney donor includes many tests, procedures and visits with doctors. It also consists of meeting with many members of the transplant team. The evaluation helps us determine if you are a good match with your potential recipient and if you are healthy enough to donate your kidney.
Please be aware that the evaluation may reveal health conditions that need to be corrected prior to donation; if they cannot be corrected, you may not qualify to donate.
Evaluation and testing
Your evaluation includes the following tests:
- Blood tests — A variety of blood tests will be performed, including a chemistry panel, hematology panel, and virology/serology panel to screen for exposure to infections, including HIV and hepatitis. You will also do a blood draw for blood typing, human leukocyte antigen (HLA) typing, and crossmatching to determine organ compatibility.
- Urine tests — Urine tests are done to screen for blood, protein and urinary tract diseases. A 24-hour urine collections is also completed to test your kidney function.
- EKG — An electrocardiogram shows how well your heart is beating and the function of your heart valves. This helps your doctor decide if your heart is strong enough for donation.
Routine healthcare — A pap smear, mammogram, and/or colonoscopy are cancer screening tests that we require based on your age, gender and family history. These tests are part of your own standard healthcare and are therefore not paid for by the Living Donor Program.
- CT scan — A computerized tomography (CT) scan with contrast will provide an image of your abdomen to check the anatomy of your kidneys, liver, spleen and bladder. This test will determine if surgery is safe, as well as which kidney would be donated.
- Chest X-ray — A chest X-ray screens for illnesses of your lungs, heart and primary blood vessels.
- Consults — You will meet with our multidisciplinary team, including a nephrologist, transplant surgeon, infectious disease specialist, social worker, independent living donor advocate, nutritionist, pharmacist, and nurse coordinator. Some of those consults will include a physical exam to assess your health. The consults will also allow you to gather more information of the Living Donation process, including the operation and related risks.
- Donor-specific testing: additional testing and/or consults may be indicated based on your age, gender, physical exam, personal medical history, or medical history of your family.
After your testing and consults are completed, the results of your evaluation will be presented to the UW Medical Center Living Kidney Donation Selection Committee. At this meeting, the Committee will determine if you are a candidatie for a living donor surgery. The Committee members will determine whether you are medically able to undergo the transplant procedure, and if you have shown that you have the social, financial and support resources for the donation.
The committee will decide one of three outcomes:
- Accept you as a donor.
- Not accept you for donation and explain why you were not accepted.
- Request additional visits and tests before they make a decision.
You will be contacted about the decision within a week of your presentation to the Committee.
The donation operation (nephrectomy)
Once you are approved as a donor, we will schedule your surgery based upon your schedule, the operating room schedule and the recipient’s schedule. During your pre-operative appointment, your surgeon will review the procedure and related risks again.
Care and recovery after surgery
After your surgery, you will recover at the hospital (inpatient unit) unit. The length of your stay in the hospital typically varies between two and four days, depending on the course of your recovery.
After you leave the hospital, you will continue your recovery at home. For the first eight to twelve weeks, your doctor will recommend limiting your daily activities.
You will meet with the living donor team approximately nine to twelve days after surgery for a post-operative appointments and blood/urine tests. For your continued health, we also request that you complete a follow-up appointment and lab tests at six months, one year and two years after your donation. These appointments and tests will be arranged through UW Medical Center, although they can be completed remotely. It is also important to maintain long-term follow-up with your primary care provider.
At UW Medicine, our multidisciplinary team ensures you get the best care possible during the Living Kidney Donation (LKD) process. Here are some of the people you’ll meet with:
- An independent donor advocate (IDA), a licensed clinical social worker, will be available to you throughout the donation process and recovery to promote your best interest and advocate for your rights. The independent donor advocate is independent of the recipient's care team. The independent donor advocate will assist you with obtaining and understanding information regarding the medical, psychological, and financial risks associated with being a living donor. The independent donor advocate will be available to you to discuss any concerns or questions you may have. The independent donor advocate will make sure that you feel comfortable moving forward with the living donation and that you do not feel any pressure to donate. The independent donor advocate will be your voice at the donor selection conference.
- A social worker — A licensed clinical transplant social worker will complete a full psychosocial evaluation, including review of your mental health and alcohol and drug use. The purpose of this evaluation is to determine if you understand the emotional, financial and physical stress you may experience as a kidney donor. This interview will also allow you to become acquainted with the support systems available at the UW Medical Center. The social worker can also recommend options for assistance with expenses not covered as part of the donation e.g., housing and transportation. A social worker will be available to you throughout the living kidney donor process to help with stress-related problems with you and your family.
- A transplant nephrologist meets with you to determine if you are a good medical candidate for donation. The nephrologist will review your medical history, ask many questions about how you are doing and what infections you might have been exposed to, plus review the medical risks for donation. A full history and physical will be performed. The nephrologist will also follow up with you after donation to review medical recovery.
- A transplant surgeon meets with you to discuss whether donation is an option for you, based on the results of your evaluation. The surgeon will also discuss the significance of having the surgery, the procedure itself, the risks of the surgery, and the possible complications after your donation and during the recovery phase.
- The nurse coordinator provides education about the donation process and your responsibilities before and after surgery. The nurse coordinator discusses test results and reviews any medical testing needed throughout the process.
- A program coordinator discusses and schedules testing and blood draws, and provides information about visits to UW Medical Center.
- A psychiatrist/psychologist may conduct a more in-depth psychiatric evaluation and assessment. Some patients with a history of drug or alcohol abuse may be required to participate in a rehabilitation program and/or to abstain from substance use prior to donation.
How do I get more information about living kidney donation?
Please contact the Living Donor Program at University of Washington Medical Center (UWMC). You can also find information online and in magazines and books.
How do I get started?
Just call the living donor phone line at 206.598.3627. We’ll do a brief phone interview and give you some information about the donation process. You’ll also have the opportunity to ask any questions you may have.
How long does the evaluation process take?
The process, from your initial inquiry to potentially being approved as a donor, takes approximately three to six months and depends upon the required tests, the test results and the recipient’s status.
Who pays for living kidney donation?
The Living Donor Program pays for appropriate testing ordered by the program. Please note that the recipient must be cleared financially and medically prior to proceeding with testing. Transportation costs and lost wages are not covered as a part of donation. However, the National Living Donor Assistance Center does provide financial assistance for travel costs. Some people may be eligible for paid leave or disability through their employer. If you have questions about financial assistance, please contact the living donor phone line at 206.598.3627.
Am I a match?
The results of three tests determine your level of match with your intended recipient:
You must have a compatible blood type to donate directly to your intended recipient. If your blood types are not compatible, then donation is possible through the donor exchange program.
A crossmatch combines the recipient’s blood cells and the donor’s blood cells to check for interaction. No interaction, or a negative crossmatch, is needed for transplant. If there is an interaction, or a positive crossmatch, then donation is possible through donor exchange. If there is a negative crossmatch, the evaluation process continues with tissue typing to determine antigen matching.
This is a blood test that determines whether your tissue is compatible with your intended recipient. Because of advances in medicine, tissue matching is not as important as it was previously, so people who are not matched for any antigens may still donate with very successful outcomes for the recipient. Please note that results from these tests can take up to 10 to 14 business days to be received.
What if I am not a match with my recipient?
If you are not a match with your intended recipient, you may consider participating in donor exchange. We participate in the National Kidney Registry for donor exchange. For more information on donor exchange, visit kidneyregistry.org.
What if I don’t live in the Seattle area?
Initial testing can be done outside of the Seattle area. You will then need to be seen at University of Washington Medical Center for further testing in order to be approved as a donor. You will also need to return to the Seattle area for surgery and recovery.
How long is the recovery?
The length of your stay in the hospital typically varies between two and four days, and will depend on the rate of your recovery and/or complications after surgery. You will meet with the living donor team approximately nine to twelve days after surgery for a post-operative appointment. Typically, you should be able to return to work within four to six weeks, but you may require longer depending on your job duties and personal recovery. If there are no complications from the surgery, you should be able to return to your normal level of activity within two to three months.
How long will the kidney last for the recipient?
It depends upon a number of factors, including what disease the recipient has, the anti-rejection medication being prescribed and the compliance of the recipient. The average is between 10 and 15 years.
What if I do not know someone who needs a kidney transplant?
If you do not have a specific transplant recipient, you can become a non-directed donor and donate anonymously to someone waiting for a transplant at UW Medical Center, at Seattle Children’s Hospital or through the donor exchange program.
Interested in finding out more about our services? Contact us and let us know how we can help.
University of Washington Medical Center
Kidney Care & Transplant Program
1959 NE Pacific St
Seattle, WA 98195
Hours: 9 a.m. to 5 p.m.
Directions to UW Medical Center
If you are a referring provider, learn how to refer a patient.
- Benefits of Living Kidney Donation video
- United Network for Organ Sharing (UNOS): Data such as the number of people on waiting lists and the number of transplants performed per year.
- Transplant Living: Information about the organ donation experience from United Network for Organ Sharing.
- National Kidney Registry: Living donors who are incompatible with their intended recipient can be placed on a national registry to find a compatible recipient, which will help their intended recipient also receive a transplant.
- OrganDonor.gov: U.S. government information on organ and tissue donation and transplantation.
- National Living Donor Assistance Center: Financial assistance for those who want to donate.
- Living Donors Online: A resource from the International Association of Living Organ Donors, Inc.; option to talk with a living donor who has already gone through the donation process.
- American Society of Transplant Surgeons: Educational videos discussing the risks and benefits of living donation.