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What are the Risks of Donating a Kidney?

National Kidney Registry

There are approximately 100,000 people in the United States waiting for a kidney, and many more living kidney donors are needed to give kidney patients a chance to receive a life-saving kidney transplant. If you are considering becoming a living kidney donor, you may be wondering whether kidney donation is safe, or if there are any risks associated with kidney donation surgery.

A new study by the Mayo Clinic confirms that the risk of major complications for living kidney donors is minimal. Of the 3,002 living kidney donors who underwent laparoscopic kidney donor surgery at the Mayo Clinic transplant center from 2000 to 2019, 12.4% had minor post-surgical complications. Just 2.5% of patients in the study experienced major complications, and all made a complete recovery. The study tracked complications that occurred up to 120 days after surgery.

“The results of this study are extremely reassuring for individuals who are considering being living kidney donors,” said Dr. Timucin Taner, chair of the Division of Transplant Surgery at the Mayo Clinic and a co-author of the study. “We found that this life-saving surgery, when performed at experienced transplant centers, is extremely safe.”

Types of Kidney Donation Surgery

There are two types of kidney donation surgery (nephrectomy) procedures to remove the kidney from the donor: laparoscopic and non-laparoscopic or “open.”

Laparoscopic kidney removal, a less invasive type of nephrectomy that uses small incisions and a special camera, was introduced in the 1990s and is now standard in the United States. Laparoscopic surgery typically results in a shorter hospital stay, less pain and scarring, faster recovery time, and fewer postoperative complications.

In cases where laparoscopic surgery is not possible, open surgery may be performed, which involves a larger incision and generally requires a longer recovery time.

Kidney Donation Risks

Kidney donation surgery is one of the safest types of surgeries, but all surgery carries some degree of risk. Risks for kidney donation surgery can include bleeding, hernia, wound infection and fever. Most postoperative complications are short-term and can be addressed with quality medical care.

Death is always a risk for any type of surgery, but the mortality rate for kidney donor surgery is .007%—significantly lower that other common types of surgery such as appendectomy (0.2% mortality rate) and gallbladder removal (0.4% mortality rate).

“Thankfully it’s a very small number and it hardly ever happens,” said Dr. David Serur, Medical Director of Kidney Transplantation at the Hackensack University Medical Center, Division of Organ Transplantation. “Part of the reason is that even though it is major surgery, the donor is a healthy person. They have been ruled out for major diseases and their risk for surgery is low.”

There does seem to be a slightly elevated risk of lifetime kidney failure for kidney donors compared to healthy non-donors (0.009% for kidney donors versus 0.0014% for healthy non-donors), but kidney donors still have a lower risk of kidney failure than the general population, which is 0.033%.

Despite some element of risk, most people who donate a kidney are able to recover quickly with minimal complications, if any. That’s important for potential kidney donors to know, because while the thousands of people waiting for a lifesaving kidney transplant may be able to get a kidney from a deceased donor, patients who receive a kidney from a living donor generally have better outcomes. Living donor kidneys can function up to twice as long as kidneys from deceased donors, and can give someone facing kidney failure a chance to live a long, healthy life.

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