Liver And Kidney Donation: The Opportunities And Challenges Of Live Donation

Very often the opportunity to donate will arise when a family member or close friend suffers liver or kidney failure.  Even in the case of an altruistic donation, (when someone donates to a stranger) the impulse to donate often comes from seeing a loved one suffer, or indeed recover when they receive a much-needed organ.  However, perhaps more impressively, some altruistic donations are now inspired by a simple desire to give something back to the world.

Ten years ago the only option for kidney donation was open surgery, but in recent years more and more kidney donations are being carried out through keyhole surgery.  This is designed to reduce the trauma and recovery time and so has opened up the option to donate for many more.

Yet however simple and straightforward the surgery may seem, it is still a highly unusual situation that presents difficult questions for donors, recipients and even medical staff, as it is essentially taking someone in good health and carrying out highly invasive, unnecessary surgery on them for the good of another.  In fact it directly contravenes one of medicine's most basic tenets "First do no harm."

Although serious problems for the donor are statistically rare, they do occur.  Even if everything goes according to plan, the surgery may well be the first time that the donor has had to spend time in hospital, or deal with the medical profession, and they may well feel as if they have been thrown in at the deep end.

The long term prognosis for kidney donors is excellent; they are statistically likely to live longer than non-donors, and it is entirely possible for female donors to become pregnant afterwards (with only a very slightly elevated chance of developing complications), but removing a kidney can be a traumatic operation with serious musculoskeletal effects, with both short and long term impact on general health.

This is not necessarily a negative thing; sometimes the focus on health and wellbeing continues.  Following surgery the donor may well have an improved attitude toward taking care of themselves – leading to a marked improvement in long-term health and fitness.

Donating a kidney is also likely to have a profound emotional impact on a living donor.  Although the success of a transplant can lead to feelings of elation, there are also sometimes negative emotions.  Many talk of feeling depressed after the operation – there is a lot of build up and anticipation beforehand and then afterwards there is a little to do but recover.  Donors can sometimes feel abandoned, particularly by the medical team as the attention is switched to the recipient.  The donor may not know anyone else who has gone through the experience and may feel isolated and unable to talk about their feelings with friends and family, which can add to the feeling of depression. 

However, just as the temporary setback in health and fitness can lead to a long term overall improvement, so too can the emotional upheaval of a donation.  Whilst donating can open donors up to potential emotional difficulties, so too can it help them to focus on their emotions, seek support if necessary and ultimately become happier in the long term. 

Some say that the Chinese symbol for crisis can also mean opportunity in a time of danger.  As well as the opportunity that living donation affords the recipient for a new lease of life after facing a medical crisis, so too can it offer the living donor a powerful opportunity:  The opportunity to reevaluate their own life; their fitness, their emotional wellbeing and even their life goals; to become the person that they truly wish to be.