Living Donation

Living Donation

The first successful living donor transplant was performed between 23-year-old identical twins in 1954. Doctor Joseph E. Murray at Peter Bent Brigham Hospital in Boston, MA, transplanted a healthy kidney from Ronald Herrick into his twin brother, Richard, who had chronic kidney failure. Richard Herrick went on to live an active, normal life, dying eight years later from causes unrelated to the transplant.

Since that time, thousands of patients have received successful transplants from living donors, which are handled by the center or hospital doing the transplant. For more information, contact one of the four transplant programs in Iowa.

Registering in the Iowa Donor Registry does not mean you will be called for living donation. Signing up as an organ, eye and tissue donor in the Iowa Donor Registry is only for donation after your death.

Iowa Methodist Medical Center
Des Moines, IA
(888) 343-4164

Iowa City VA Medical Center
Iowa City, IA
(319) 338-0581

University of Iowa Hospitals and Clinics
Iowa City, IA
(800) 777-8442

Mercy Medical Center
Des Moines, IA
(515) 247-3121

Organ Types for Living Donation

Living donor transplants are a viable alternative for patients in need of new organs. Many different types of organs can be delivered by living donors, including:

Kidney

This is the most frequent type of living organ donation. For the donor, there is little risk in living with one kidney because the remaining kidney compensates to do the work of both kidneys.

Liver

Individuals can donate segments of the liver, which has the ability to regenerate the segment that was donated and regain full function.

Lung

Although lung lobes do not regenerate, individuals can donate a lobe of one lung.

Pancreas

Individuals can also donate a portion of the pancreas. Like the lung, the pancreas does not regenerate, but donors usually have no problems with reduced function.

Intestine

Although very rare, it is possible to donate a portion of your intestine.

Heart

While extremely rare, a domino transplant makes some heart-lung recipients living heart donors. When a patient receives a heart-lung “bloc” from a deceased donor, his or her healthy heart may be given to an individual waiting for a heart transplant. This procedure is used when physicians determine that the deceased donor lungs will function best if they are used in conjunction with the deceased donor heart.

Qualifications for Living Donors

In order to qualify as a living donor, an individual must be physically fit, in good general health, and free from high blood pressure, diabetes, cancer, kidney disease, and heart disease. Individuals considered for living donation are usually between 18-60 years of age. Gender and race are not factors in determining a successful match.

The living donor must first undergo a blood test to determine blood type compatibility with the recipient. If the donor and recipient have compatible blood types, the donor undergoes a medical history review and a complete physical examination. The following tests may be performed:

Tissue Typing

The donor’s blood is drawn for tissue typing of the white blood cells.

Crossmatching

A blood test is done before the transplant to see if the potential recipient will react to the donor organ. If the crossmatch is “positive,” then the donor and patient are incompatible. If the crossmatch is “negative,” then the transplant may proceed. Crossmatching is routinely performed for kidney and pancreas transplants.

Antibody Screen

An antibody is a protein substance made by the body’s immune system in response to an antigen (a foreign substance; for example, a transplanted organ, blood transfusion, virus, or pregnancy). Because the antibodies attack the transplanted organ, the antibody screen tests for panel reactive antibody (PRA). The white blood cells of the donor and the serum of the recipient are mixed to see if there are antibodies in the recipient that react with the antigens of the donor.

Urine Tests

In the case of a kidney donation, urine samples are collected for 24 hours to assess the donor’s kidney function.

X-rays

A chest X-ray and an electrocardiogram (EKG) are performed to screen the donor for heart and lung disease.

Arteriogram

This final set of tests involves injecting a liquid that is visible under X-ray into the blood vessels to view the organ to be donated. This procedure is usually done on an outpatient basis, but in some cases it may require an overnight hospital stay.

Psychiatric and/or psychological evaluation

The donor and the recipient may undergo a psychiatric and/or psychological evaluation.

The decision to become a living donor is a voluntary one, and the donor may change his or her mind at any time during the process. The donor’s decision and reasons are kept confidential. Education is the most important component in this decision and anyone considering becoming a hero as a living donor should contact one of the state’s nine transplant programs or visit the United Network of Organ Sharing’s website at www.unos.org.