Perhaps the most common question of a potential kidney donor is, “What are the long-term consequences to my health of living with one kidney?”
Some medical research on the long-term effects of living kidney donation has been conducted, and there is need for much more research. In the meantime, the general conclusions from research to date are:
- The general health and kidney function of living kidney donors are as good as the general population.
- The mortality rate of living donors is better than the general population, possibly because living donors, prior to donation, tend to be healthier than the general population.
- Where differences in health in the donor population have been found, there have been slightly higher incidences of high blood pressure (hypertension), excess protein in urine (proteinuria), and preeclampsia in pregnant women.
If you have ongoing complications from your donation, keep in touch with the transplant center.
Staying Healthy After Donation
Medical studies suggest there are few health consequences from donating a kidney. However, some precautions naturally are in order. For example, you may need to limit or give up activities that could damage your remaining kidney, such as rough contact sports (for example, boxing or American football).
As noted above, some studies have shown a slightly higher risk of high blood pressure and proteinuria. These risks can be monitored through regular physical exams, blood tests, and urine tests. Interestingly, Switzerland established a living donor registry in 1993 to track living donors and to ensure they are regularly examined by their personal physician for blood pressure and renal functions. No such registry or post-operative protocols exist in the U.S. or other countries. U.S. transplant centers are required by UNOS to follow up with you after six months, one year, and two years. To date, adherence to this requirement has been limited, submissions are incomplete, and the results are not used in constructive ways (e.g., research). The UNOS Living Donor Committee has proposed a standard medical and psychosocial follow-up protocol, but UNOS has yet to adopt the suggestions.
Pregnancy typically is not a problem following donation, but a female donor should let her obstetrician know she has only one kidney so kidney function can be monitored during the pregnancy. One recent study in Norway indicated an elevated risk of preeclampsia among women who had been living kidney donors. Physicians recommend waiting at least two months following kidney donation before getting pregnant. You can find more information by searching the LDO message board, where several LDO participants have left messages describing their experiences with pregnancy following donation.
Transplant teams also frequently warn living donors to avoid certain medications that are “nephrotoxic,” meaning they are potentially damaging to your one remaining kidney. Categories of medicines typically mentioned include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.
- Cold and allergy medicines that include NSAIDs.
- Fleet enemas.
- Certain heartburn medicines such as Tagamet HB and Alka Seltzer.
In addition, check with your doctor about the safety of vitamins, supplements, and herbal remedies.
Here is an example of a list of “safe” and “not safe” drugs prepared by a health care system for its kidney donors.
Keep in mind that these kinds of medicinal restrictions can play a role in limiting treatment options if you contract chronic diseases or require ongoing pain management, perhaps later in your life.
You should also consider your psychological health after donation. For example, some living donors on LDO report feeling depressed for a while shortly after donation. This feeling may be the result of fatigue following surgery, renewed demands on you by family and work while you are still recovering, or the sudden letdown following a major life event that had been marked by lots of energy, anxiety, and attention from others. A medical research study showed that nearly 11% of living donors were prescribed anti-depressants following donation.
Your mood can also be influenced by what happens to the recipient of your donated kidney. The recipient may reject the organ or may die despite the transplant. It’s natural to go through a grieving process in this circumstance. If your feelings of sadness persist, please get professional help. Fortunately, recipients often have significantly improved health immediately, and donors report feeling very satisfied, rewarded, and relieved by such an outcome.
If you donated to a spouse, family member, or friend, the nature of your relationship with that person may change. In some cases, it may be negative. You or the recipient may feel guilt, indebtedness, conflict, or regret and experience manipulation and other destructive behavior. Seek professional counseling if your relationship becomes dysfunctional. Fortunately, most living donors report a great improvement in their relationship with the recipient and family members after the donation.
Additional Issues that May Arise
Here are two additional issues related to donating a kidney you should be aware of are:
- Potential loss of insurance or insurability. Some LDO visitors have reported losing insurance (medical, disability, or life insurance) or being told they could not get or increase insurance coverage because of the donation. If there have been no ongoing complications from your donation, you should not lose coverage. In fact, as research has shown, living donors tend to be healthier and live longer than the average population. If you find that your insurance status has changed, please contact us at firstname.lastname@example.org. We will do what we can to help you get your insurance coverage back.
- Loss of kidney function. Some living kidney donors have lost the function of their one remaining kidney. One study that looked at the UNOS kidney waiting list from January 1, 1996 through February 28, 2009 found 194 people who had previously been living donors. The study also noted that the number of previous living kidney donors subsequently placed on the kidney waiting list within five years of donating “is very small [.02%].” Medical researchers have calculated the prevalence of ESRD among living kidney donors is as low as 0.11% and as high as 1.1%. If a living donor needs a transplant, UNOS gives the person an additional four points when placed on their transplant list, which has the effect of shortening the wait time for a deceased organ donation.
About Living Kidney Donation
- Why living kidney donation?
- The tap on the shoulder (being asked to donate)
- Now…about your health (donor evaluation)
- The gift (the surgical process)
Information Source: http://livingdonorsonline.org