Becoming a Living Donor
The donation experience can be a wonderfully rewarding experience. Most donors feel very good about their decision to donate because they have helped to save or improve the life of another individual. However, the decision to donate a kidney or portion of your liver is one to be taken seriously. Anyone considering donation should consider the following information in their decision making process and are encouraged to discuss their decision with people close to them.
When donating to a family member, it is often helpful to discuss the decision with someone outside of the family, such as a close friend or co-worker, who may be able to provide an objective perspective. Nurse Coordinators and a Living Donor Social Worker are also available to answer questions that potential donors may have to help them with their decision making process.
In addition to considering the medical aspects of donation, individuals are strongly encouraged to consider the following information in making their decision to donate.
It is very important to be clear and honest with yourself about your motivations for donating. Take time to reflect on your motivations and feelings about the donation. Donating a kidney is a very individual decision. For some people it is a fairly easy decision, as in cases where an individual's primary motivation is to save or improve the life of a loved one who is critically ill. Yet, others may feel a sense of obligation or pressure to donate. It is also possible for some individuals to wish to donate, but also feel nervous and apprehensive about the decision.
Therefore, it is important to take time to consider exactly what your motivations are behind the donation and discuss your feelings with someone you trust.
Some things to consider:
- Am I freely considering donation primarily because I want to help improve the quality of life of a loved one?
- Am I considering donation because I feel a sense of obligation?
- Do I feel pressured?
- Am I expecting anything as a result, such as an improved relationship with the recipient, a better social standing, or is the donation a way for me to make up for past mistakes?
- What are my expectations for the surgery and its outcome for the recipient? What are my expectations for the surgery and its outcome for me?
Living donation can be a stressful experience for some people, so it is important that a donor has people in their life that will be available to provide emotional support throughout the experience.
An individual's decision to donate may also affect those close to them, such as a significant other or parent. Therefore, it is important for the donor to discuss their wish to donate with them, especially if these individuals may serve as support persons post-operatively during the recovery period. Ideally, the emotional supports for the donor should be supportive of the decision so that they can be helpful to the donor.
Some Things to Consider:
- How does my significant other/close family feel about my decision to donate?
- Are they supportive or are they against the decision?
- If I pursue the donation and do not have the support of my significant other, will this affect my relationship with them?
- Will they be supportive of me and my decision if the outcome of the surgery is not what is expected?
- How will I feel if this is the case?
Because the donation process can be unpredictable and stressful at times, it is important for donors to be emotionally stable.
For example, there is extensive testing that is required for donors, and while the center attempts to make the testing convenient, it is possible that during the work-up donors will be asked to repeat tests, which may require them to take time away from work or their daily routine on more than one occasion.
Also, it is possible that a surgery may be rescheduled because of changes such as new test results, operating room availability, or changes in the recipient's or donor's health status, etc. Flexibility and positive coping mechanisms for ambiguity and stress will be important in handing these potential changes.
Although the great majority of living donor transplant surgical outcomes is positive for both the donor and recipient, as with any surgery, outcomes are not guaranteed. It is possible that an outcome may be different from one’s expectations. It is important that the donor considers this possibility and examines whether they have adequate coping mechanisms and social supports that would assist them in dealing with this potential stress.
Some Things to Consider:
- What do I normally do to make myself feel better when I feel stressed or when a situation is out of my control? (i.e., talking to others, praying, exercising, gathering information to clarify questions, etc.)
- Are my coping mechanisms healthy and effective?
- Would I feel comfortable sharing feelings with someone close to me, the donor social worker, or another mental health professional?
It is important for donors to consider the potential financial implications of donation, particularly because they will need to plan to take time from work for the surgery and recovery period. Typically, most donors are able to return to work 2-3 weeks post-donation. This time period may be longer depending on the physical demands of their job. For individuals who work at a job that is not physically demanding (i.e., desk job), they are likely to return to work within 2-3 weeks. However, those whose jobs require heavy lifting should know that the surgeons usually recommend lifting restrictions of no greater than 20 pounds for 6 weeks.
Some Things to Consider:
- Do I have enough paid time off to cover my expenses during my hospitalization and recovery periods?
- Does my employer offer short-term disability and/ or Long-Term Disability? (Donors are encouraged to check with their Human Resources Department to confirm what benefits are available to them.)
- If my significant other is my support person, can we afford for them to take off some time during my surgery and recovery periods if they do not have paid leave?
- If I will not have paid leave during my time off, do I have savings that can cover my expenses?
- Do I have enough time to accrue savings that can be used during this time?
- If I am without income during my time away from work, will this cause me a great deal of stress? How will I deal with this stress?
- If my recovery takes longer than expected, how will my finances be affected?
- Are there family or friends that I can depend on if I encounter financial difficulty?
It will be very important for donors to have a family member or close friend involved with their care during their hospitalization and once they return home from the hospital.
Once the donors return home from the hospital, they will likely need some extra help with things for a short time such as grocery shopping, meal preparation, household chores, transportation, and other activities that donors normally would be able to do independently. Also, if donors have small children, they will need to consider their childcare needs.
Donors will need to have someone readily available to them to assist with these tasks for the first few days after discharge when they are tired, sore, and in the midst of recovery. This time period may be longer for some patients. Please keep in mind that although the recovery period for donors is an average of 2-3 weeks, it is during the first week that they usually need the most assistance. It is wise for donors to plan to have 24-hr help available to them for the first 3 days after discharge from the hospital, but many benefit from having help throughout the first week.
In cases where the donor lives with the recipient, it is important for donors and recipients to know that a separate support person will be required for each of them, since they will have their own recovery needs. (Please note that the donor is not an acceptable support person for the recipient.)
Some Things to Consider:
- Do I have someone who is reliable, available, and able-bodied to assist with some of these tasks for which I will need help?
- Do I have a support person be available 24 hours for at least 2-3 days after I return home from the hospital? Will they be available for an extended period of time?
- Do I have a reliable plan for childcare?