The demand for organ transplants is high. The United Network for Organ Sharing reports that more than 100,000 people are waiting for transplants right now.
What many don’t realize is that living donation is a lifesaving opportunity for people in good health. For example, a living kidney transplant can help someone with chronic kidney disease dramatically improve their quality of life. Read more about how a wife donated a kidney to her husband 11 years ago with excellent results.
Living kidney donation benefits recipients in the following ways:
- Decreased time on dialysis or even avoiding dialysis completely
- Greater long-term success rates for the transplant
- Decreased time spent on the organ donor waiting list
- A return to caring for family and work responsibilities
“Kidney transplant surgery is one of the most rewarding operations we do,” says Dr. Vincent Casingal, chief of the division of abdominal transplant surgery at Atrium Health Carolinas Medical Center. “We can see a change in the recipient’s health immediately or within a few days. When we meet a person who’s willing to go through surgery to help someone else, it’s very rewarding to be part of that story.”
In 2023, there were 27,332 kidney transplants in the U.S. However, only about 23% of those transplants were from living donors. This reveals an opportunity for living donors to become part of a big solution.
Atrium Health Transplant Center, a facility of Carolinas Medical Center, is focused on building trust in living donation throughout the community.
“Everyone has their own fears and concerns about organ donation,” explains Tania Feemster, living kidney donor coordinator with Atrium Health Transplant Center. “Some people don’t think twice about jumping right in to help a family member. But for others, it’s a big decision. Our goal is to assure potential donors that we’re their advocates and we won’t put them in any danger.”
“We’re educating potential donors on the risks and benefits of donation,” adds Lorrie Lockwood, registered nurse and certified clinical transplant coordinator with Atrium Health Transplant Center. “This includes discussing details related to the extensive evaluation, recovery and life beyond donation. We want to help donors give proper informed consent before proceeding with their gift of life. Throughout the process, donor health is our No. 1 priority.”
Potential donors meet with a social worker during the evaluation process to discuss any misconceptions or potential barriers to donation.
Living donation myths vs. facts
Myth: I must be related to the recipient to qualify as a donor.
Fact: Anyone can donate as long as they are medically approved. The blood types of the donor and recipient must be compatible.
If the blood types don’t match, a kidney paired exchange may be an option. The exchange involves other pairs of living donors and transplant candidates who don’t match their intended recipient. The candidates exchange donor kidneys so that each candidate receives a kidney from a donor with a compatible blood type.
Myth: I wouldn’t qualify because of my race.
Fact: “We look at each potential donor as an individual,” Feemster explains. “Many factors related to health and background go into the evaluation process. We include potential donors in this discussion upfront.”
Myth: Donating an organ is too expensive.
Fact: Donors are not responsible for any costs associated with evaluation or surgery. It is recommended that donors take care of their own routine health maintenance and carry medical insurance.
“We can provide a lot of resources to help donors,” says Joslyn Brown, assistant vice president of transplant with Atrium Health Transplant Center. “They can get grants to help with travel and hotels. Plus, many employers are seeing the value of donation and allowing employees to take paid leave to donate.” (Atrium Health offers all employees six weeks of paid leave for organ donation.)
The National Living Donor Assistance Center can provide help with lost wages. If donors don’t have paid time off for donation, the National Living Donor Assistance Center will pay them up to four weeks of lost wages during recovery.
Many of the screening appointments can be done virtually. This allows potential donors – even those from out of state – to meet with some of the multidisciplinary team members with minimal disruption to their work schedule. Some donors can have their lab work done close to home.
Myth: Donating a kidney will put my health at risk.
Fact: Potential donors go through extensive testing, including genetic testing, cardiac testing, imaging/CT scans and lab work (which includes kidney function testing and nuclear testing).
“If we find concerns, we won’t let you do it,” Feemster explains. “Our goal is to maintain donor safety above anything else. We want both our donors and recipients to be able to return to their normal lives safely.”
“We rule out a lot of people with health issues related to weight and diabetes,” she adds. “It’s very beneficial to come here for an evaluation. Even if you don’t end up donating, we can find out how you can improve your health and prevent further issues down the road. We’ll have you follow up with your doctor if any findings are concerning.”
Myth: I can’t live with only one kidney.
Fact: Being a living donor doesn’t put anyone at any higher risk for developing kidney disease than the general population. Potential donors go through extensive testing to make sure they have enough function to sustain the loss of one kidney, which results in a 25%-30% loss of kidney function. If the potential donor’s kidney function can’t support it, the evaluation process ends.
Myth: Once I start the process, I can’t change my mind.
Fact: There’s no contract involved. If you decide not to donate, you can stop at any time.
“We always welcome talking to people who want to learn more about donation,” explains Casingal. “Just because you’re interested in donating an organ doesn’t mean you have to. It might not be right for you. Only one out of every 10 or 11 patients goes on to donate a kidney.”
“We spread the evaluation workup over several visits to allow patients time to consider everything involved,” he adds. “It’s important to build in time to let them decide if it’s the right thing to do.”
Myth: Recovery from donation will take a long time.
Fact: The hospital stay following donation is two to three days. A few days after returning home, the donor has a virtual visit with the doctor to ensure everything is going well. Donors are then checked at two weeks, eight weeks, six months, one year and two years after the procedure.
“We’re required to follow donors for two years, but we’re in it for the long haul,” Feemster notes. “We’re always a phone call away and can answer any questions you have 24/7. We’re here for you as long as you need us.”
Safety and privacy
In addition to extensive testing and screening, donors are cared for by a large team of experts. The transplant team includes attending physicians who are responsible for donor health. Donors have the same living donor coordinator from beginning to end.
Living donors and recipients each have their own separate team of caregivers to prevent any conflicts of interest. All personal information from donors remains confidential.
In addition, every donor is required to have a living donor advocate. This is a neutral, third-party physician who stays with the patient throughout the evaluation and donation process. The donor advocate consults with the patient’s social worker and care team and has veto power if any issues arise during the process.
“While some hospitals might assign a chaplain, nurse or social worker to this role, Atrium Health Transplant Center uses a physician independent living donor advocate,” notes Feemster. “The advocate is skilled at talking through issues and coordinating with the donor’s care team.”
Experience and results
Atrium Health Transplant Center at Carolinas Medical Center has been a leading center for kidney transplantation since 1970, when the first kidney transplant was performed. The transplant team, which includes nephrologists, transplant surgeons, donor surgeons and coordinators, has performed more than 6,000 organ transplants to date.
“Our experienced transplant team has been working together for almost 20 years,” explains Casingal. “We have some of the best long-term outcomes for kidney transplant. Also, we offer our donors follow-up care with our nephrologists for a lifetime.”
Heroes in the community
Lockwood has worked with all types of kidney patients. Her career started in dialysis and involved working with sick kidney patients who needed support. Then she transitioned to the transplant side, where she worked with patients being evaluated for the kidney transplant list. She now works with living donors, a job she finds especially meaningful.
“Potential donors are choosing to have an elective surgery to help either a loved one or a stranger,” Lockwood says. “It’s so important that we give them the care they need and help them feel at ease. We are always available – even years after donation. Our donors are our heroes and should be treated like heroes.”
Atrium Health Transplant Center experts want to be seen as a valuable resource in the community.
“If you have a family member with kidney disease, we want you to feel comfortable talking with us,” notes Feemster. “Don’t be afraid to call. We have teams ready to talk through your questions and concerns. Even if you don’t end up donating, we can help you understand the process – and your health – better.”
Learn more about living donor kidney transplants. Or call Atrium Health Kidney Transplant Living Donor Office at 704-355-3602.
