Transplant Surgery

Living Donor Services | Cadaveric Transplants  
Special Responsibility to Our Donors

Living Donor Services

Living Donor Transplants

• A living donor transplant is a kidney transplant in which a kidney is given to the patient by another living person.
• This living person may fit into one of two groups
      - Blood relative (living related donor transplant): such as a parent, sister, brother or child.
      - Non-blood relative (living unrelated donor transplant): such as a husband/wife, stepchild, or adopted parent or child or close friend.
• Living donation is preferred because it offers the best opportunity for the highest quality kidney and the shortest waiting time.
• The living donor is thoroughly evaluated to make sure that the removal of a kidney will not harm his or her health. This process is done by a different doctor than the one who evaluates the recipient.
• Being a living donor does not put the donor at increased risk for future health problems.
• There is no guarantee that someone who wants to donate a kidney will in fact be able to due to a variety of health, emotional or social issues.

Sometimes a person may want to donate a kidney to you but cannot because the kidney is not compatible with you. Additional options this case include:

NEPKE (the New England Program for Kidney Exchange):   

You and your donor are entered into a registry with other donor-recipient pairs who cannot donate to each other. We will try to find another pair in which that donor can donate to you, and your donor can donate to the other recipient.

Donation “to the list”: Your living donor gives their kidney to a patient on the transplant wait list and in exchange, you then go to the top of the waiting list for the next available kidney.

Your transplant team will tell you if either of these options are a good choice for you.

Cadaveric Transplants

• If receiving a kidney from a living donor is not an option, your name will be placed on the national waiting list for a deceased donor kidney.
• A deceased donor kidney is a kidney  taken from a person who has suffered brain death. The family of this donor has made the decision to offer their kidney for transplant to help others.
• Kidneys from deceased donors are a precious national resource and a nationwide program is designed to allow equal access to all patients who need a kidney for transplantation. This national system balances the needs of patients who have waited a long time with the goal of transplanting well matched kidneys.
• In general, the wait for a deceased donor kidney is longer than for a living donor kidney and there is no guarantee that you will receive a deceased donor kidney

Expanded Criteria Deceased Donor Transplants

Because the supply of deceased donor kidneys is not enough for all the patients waiting for kidneys, our transplant center is willing to accept SOME kidneys from deceased donors that may be slightly less than perfect.  This means the kidney donor has one of the following criteria:

• Age over 60
• Age over 50 with one of:
  • High blood pressure history
  • Stroke as cause of death
  • MILD kidney damage at the time of death (Cr 1.5-2.0 mg/dL)

Many of these kidneys function very well for several years however there is an increased risk of early and late kidney loss.

Special Responsibility to Our Donors

Patients usually choose to have surgery because the operation will help them (benefits outweigh risks). Living kidney donors, however, undergo surgery entirely for someone else's benefit. Our recognition of our special responsibility for these unique individuals is the core of our program. 

Our Donors Have Their Own Advocates

Our donors have their own nephrologist (one who is not involved with the transplant patient's care). This doctor advocates for the donor independently of the transplant recipient.

Our Donors Undergo a Thorough Workup

Our workup is complete and uses the latest technology, including 3D MRI. In fact, sometimes we uncover medical problems the donor candidate is not aware of.

Benefits of Laparoscopic Procedure

Laparoscopic kidney donation, done through small incisions, represents a major improvement for donors. At the Brigham, we have uniquely refined this technique to a high level of safety for the donor, without compromising the quality of the transplanted kidney. For these reasons, virtually all Brigham donors are now done laparoscopically.