I must admit: When I was given the task of writing about living organ donation, I didn’t know what it really meant. I thought it was about ensuring that people, while living, agreed to donate their organs once they’d passed away, rather than leaving it to family to decide at a time when they’re grieving.  

But, as I’ve since discovered, living organ donation is a wonderful gift between two people—one who is trying to survive and another who is very much alive and well.

Living organ donation is when someone donates one of their kidneys or liver to someone who needs a transplanted organ to survive. There are currently 113,000 people across the U.S. in need of a transplant; and, according to Donate Life America, 86% of those need a new kidney. There simply aren’t enough organs from those who’ve passed away. 

How does the donation process work? 

As Martin Entwhistle, MD, of Marshall Medical Group explains, there are three ways to donate an organ:

• Directed donation: You donate your organ to a specific person—either a family member, someone you know, or a stranger you’ve heard about.

• Non-directed donation: You donate an organ, but do not name a specific recipient. Your transplant center gives the organ to a medically compatible recipient.

• Paired donation: You want to donate a kidney to a loved one, but you aren’t compatible, so you “trade” with another donor/recipient pair. Their recipient gets your kidney, and your loved one gets their donor’s kidney. A paired donation can involve multiple donors and recipients.

It’s also important to note that children can receive adult kidneys (see Isaac and Jeffrey’s story!).

 How long does the process take?

Both donor and recipient need to have a lot of tests, as you might imagine, to ensure compatibility. It’s a fine balance between the urgency of the recipient’s need of the organ and ensuring that the transplant will be a success. 

The process takes approximately four to five months in total.  Stephanie Baroni, living kidney donor transplant coordinator at UC Davis Health, tells me, “It can take about three to four weeks to start the process and find out blood type compatibility. The second part of compatibility is where we check to see if the recipient has antibodies against the donor, which can take around three months.  The work can be much shorter if a donor is very motivated and the recipient is ready for surgery.”

What about the operation?

Kidney transplants are simple, and the surgery involves just small incisions. The recipient and donor are in operating theaters next to each other so that the kidney can be transplanted as quickly as possible. For the donor, one kidney can do the work of two; for the recipient, the new kidney should start working immediately.  Recovery time for both is a couple of months if all goes well. 

Liver donation is more complicated. We only have one liver, so a sliver is taken from the donor, which involves major abdominal surgery. The existing liver regenerates for the donor and the new liver does the same for the recipient, but recovery time is longer due to the surgery involved.

What’s the biggest challenge of living organ donation?

“Living donation can be challenging because we’re taking a healthy organ from a healthy individual. Education is the key to a successful transplant. Not everything goes smoothly, but with education you can help each situation by sharing the possible outcomes and educating on how we deal with those outcomes,” says Baroni. 

Rejection of the organ by the recipient is a big challenge.  Their immunological process fights to reject the organ, just as our bodies try to fight a cold or infection. But, as Dr. Entwhistle elaborates, help is at hand. “The living donor and the recipient are matched for immunological compatibility and in most cases medications that suppress immunological responses are also used by the recipient post-transplant.”

Isaac Wadding, 13, who received a new kidney in January, was in the hospital for two weeks at the end of March. “He had a CMV infection, which came with the donor kidney and is very common. He was on an IV antiviral and his medications were adjusted to increase the white blood cell count,” his mom Juli explains. 

How can you donate an organ? 

If you feel inspired to donate an organ but don’t know of a recipient, then you might want to join Donate Life America’s National Donate Life Registry (donatelife.net). You need to be over 18 years of age and in good health both physically and mentally.

You’re not paid to donate your organ, but the recipient’s insurance company will cover your medical expenses. 

“To be a living donor is a generous and life-saving gift. It’s also a big decision [so it’s] important to consider all the factors—from practical issues like recovery time and time off work, to thinking about how you might feel post-transplant,” explains Hilary Klein from Donate Life. 

Isaac’s donor, Jeffrey, found the experience humbling but rewarding. 

“Without the surgeons, doctors, nurses, and medical staff none of it could have happened. They had to spend years of their life becoming educated and trained. I don't think that I should really be getting so much of the credit. I also know now that a lot of people in Isaac and his family's life put in a lot of time and effort to find a donor for him. It really was a whole community of people coming together to make it happen.”  

ISAAC WADDING

When Isaac Wadding was just three months old, he was diagnosed with chronic kidney disease; despite growing into a strong 13-year-old, it was clear that he was going to need a new kidney.  Isaac’s family distributed fliers around Folsom to try and find a donor. Though it may sound like a bizarre way to find a literal lifesaver, after contacting families, fliers and social media posts are common routes to successful living organ donation.  

“In August 2023, I was at Beacon Hill Park with my wife and daughter. My wife pointed out a flier that was taped to the water fountain. That was the first time I learned about Isaac and his condition. When I got home, I read about kidney donation. I also read a little bit more about Isaac and his illness. As a parent, I sympathized with his family and what they were going through. I could only imagine the feeling of helplessness; just having to wait and hope that something good happens,” says Jeffrey, Isaac’s donor. 

Both Isaac and Jeffrey endured many, many tests to ensure compatibility; fortunately, the surgery went well for both in January 2024. Jeffrey was back to running shortly afterwards and Isaac’s body accepted his new kidney very quickly despite a brief infection. Mom, Juli, tells me, “Since his transplant he is like a new kid—happy, laughs a lot, and loves to talk!”

by Caroline Kings
Main Photo © Chinnapong - stock.adobe.com. Photos of Isaac Wadding courtesy of Isaac Wadding's family.