Innovative, Less Invasive Surgery | What to Expect | How to Become a Living Kidney Donor

The Transplant Program at the University of Maryland Medical Center (UMMC) is leading the way in providing less invasive surgery for kidney donors.

Our surgeons have performed more than 1,500 laparoscopic donor nephrectomies (kidney donor surgeries) since 1996.

Learn more about kidney transplant.

Innovative, Less Invasive Kidney Donation Surgery at UMMC

In 2009, University of Maryland surgeons were the first in Maryland and the third in the U.S. to use single-incision laparoscopic donor nephrectomy. Patients leave the operating room with just a bandage over a 1-inch incision through the belly button.

Standard laparoscopic techniques require 4 port sites (each 5 to 12 millimeters) and a 4- to 5-inch incision to remove the kidney. Older, open surgical techniques required an incision about 10 inches long that cuts through abdominal muscles and sometimes bone.

Our single-incision laparoscopic technique has made kidney donation even less invasive than standard laparoscopic techniques. Here is how it works:

  1. We make a single, small incision through the belly button.
  2. We insert a camera and multiple instruments into the abdomen to perform the surgical procedure. 
  3. At the completion of the surgery, we stretch the incision to safely remove the kidney. 
  4. Once closed, the incision appears approximately 1.5 inches long.
  5. The single port technique can mean less pain, no sutures or staples, a shorter hospital stay and a much faster recovery for the donor.

This technique has been referred to as single-incision laparoscopic surgery (SILS), embryonic natural orifice transumbilical surgery (e-NOTES) or laparoendoscopic single-site (LESS) surgery.

Living Donor Kidney Donation: What to Expect

At UMMC, we have pioneered single-incision laparoscopic kidney donation to make the surgery and recovery as fast and painless as possible. Here’s what you can expect if you choose to donate a kidney:

Living Donor Kidney Evaluation Process

When you offer to donate a kidney, you will go through a careful evaluation process:

  1. A nurse coordinator will review your health information, walk you through laboratory testing to confirm your compatibility with your recipient and discuss our paired kidney exchange program if it makes sense for your situation. The donor and recipient sometimes come together for blood testing, but travel is not necessary at this point if you live outside Baltimore.
  2. You will have a day of testing at our Baltimore hospital. Sometimes a second day is needed to confirm your heart health. If you live far away, you can have testing done in your community and have the results sent to us.
  3. You will meet with the surgeon and nurse coordinator so that we can answer all of your questions about kidney donation.
  4. Within about a week, we will let you know if you have been approved as a kidney donor. We select kidney donors whom we are confident can return to their normal lives after the surgery. 

Living Donor Kidney Surgery

After you are approved as a kidney donor, we will schedule your surgery at a time that is convenient for you and the recipient. Here's what you can expect:

Before the procedure:

  1. Donors and recipients come to our Same Day Surgery unit. You will be able to see each other and talk before your surgery. Family can join you, too.
  2. We will do some final tests to make sure you are ready. These might include a physical exam, blood work, X-rays, an EKG or other tests to make sure you do not have an infection or other issue that could cause problems with the transplant.
  3. In operating rooms that are next to each other, we gently put the donor and recipient to sleep and prepare for surgery.

Procedure:

  1. Surgeons usually make a small laparoscopic incision near the belly button to remove the donor's kidney. The surgery takes 2 to 3 hours for the donor.
  2. During the surgery, a social worker donor advocate meets with the donor's family and friends at the hospital as needed.
  3. The surgeons close the surgical incision, and the patient goes into recovery.
  4. Meanwhile, a different surgical team immediately implants the kidney in the recipient.

After the procedure:

  1. The donor always has a private room where family and friends can visit after the surgery.
  2. The donor often is up and walking the next day. You will be able to visit your kidney recipient. You will be discharged from the hospital in 1 to 2 days.
  3. Some patients opt to have a “tummy tuck” (panniculectomy) procedure at the same time as the kidney donation. This procedure has a longer recovery than the kidney donation, but you will have only one combined recovery period.

Watch a video to see how the living donor kidney surgery is performed in the operating room. (Disclaimer: Video shows graphic images from the actual surgery.)

What to Expect After Kidney Donation

You can lead an active, normal life with only one kidney. After recovering from surgery, you will be able to work, drive, exercise and participate in sports.

We know that donors have lots of questions. Our living donor transplant coordinator will be available to answer all of your questions throughout the process.

Here’s what you can expect during your recovery:

  • Kidney function: The kidney begins functioning immediately in the recipient. The donor’s remaining kidney quickly returns the donor to nearly 100 percent kidney function.
  • Follow-up care: The donor returns in 1 to 2 weeks for a post-operative exam. After that, we examine donors at 6 months, 1 year and 2 years after surgery. Donors who live far away can be examined locally and have lab results sent to us.
  • Recovery: Donors’ long-term results are generally excellent. Donors usually have a quick recovery. Kidney disease after donation is rare thanks to our thorough pre-donation workup.
  • Rare complications: In rare instances, some donors may receive a diagnosis of kidney failure for reasons that would have been the same whether they had one or two kidneys. If that does happen, donors receive additional points on the transplant waiting list to help them receive a kidney transplant sooner. 

Meet our transplant nurse coordinators and learn more about kidney transplant.

How to Become a Living Kidney Donor

For additional information about our kidney transplant program or to speak to someone about becoming a living kidney donor, please call 1-410-328-5408 or 1-800-492-5538.

If you are interested in becoming a living kidney donor, please download our questionnaire.

For referring physicians

To refer a patient or get more information, please call 1-800-373-4111. A physician service representative from Consultation and Referral Services will direct your call to the appropriate physician or department.

For more details, please visit our section for referring physicians.