Transplants from living donors offer major benefits for a patient in need. A Keck Medicine of USC transplant surgeon answers common questions about the lifesaving process.
Living-organ donation is becoming more widely adopted across the country.
Thanks to medical advancements and improved education, thousands of people can make a difference each year by giving a functioning part of their body — either to a loved one or to an anonymous recipient — with safe and effective surgery.
“After going through the process, most donors say they’d do it again,” says Yong K. Kwon, MD, FACS, a transplant surgeon at the USC Transplant Institute of Keck Medicine of USC. “Knowing that they saved somebody’s life, especially someone they care about … it’s a priceless feeling.”
Dr. Kwon shares answers to some common questions about living-organ donation.
Which organs can be donated while alive?
It is possible for living organ donors to donate:
- One kidney
- Part of the liver
- Part of a lung
- Part of the pancreas
- Part of the intestines
Keck Medicine specializes in living-donor liver transplants, liver transplants and kidney transplants.
Kidney transplants are the most common form of living organ donation. Nationwide, they accounted for more than 90% of the 6,543 total living-donor transplants completed in 2021, according to the Organ Procurement and Transplantation Network (OPTN).
The USC Living-Donor Liver Program at Keck Medicine has received a Center of Medical Excellence designation from Blue Cross Blue Shield. We are pioneers in living-donor liver surgery, performing our first procedure in May 1999. Our medical center is also one of the few places to offer bloodless living-donor liver transplantation for patients who refuse blood products.
“Living-donor liver transplants require more surgical expertise, and only a few specialized centers even offer living-donor liver transplants,” Dr. Kwon says. “We are very good at it. Our surgeons are highly experienced and passionate.”
Although it’s possible for a living individual to donate part of their lung, pancreas and intestines, those transplants are rare in the United States. Fewer than 600 of these surgeries have been performed since the late 1980s, OPTN data shows.
Who is eligible to donate an organ?
Adults who are age 18 and older can be living organ donors. At Keck Medicine, potential donors undergo a series of physical and mental evaluations to ensure they are healthy enough for a transplant, including:
- Blood and urine tests
- CT scan
- Chest X-ray
- Electrocardiogram (EKG)
- Blood pressure monitor
- Psychosocial evaluation
- Nutritional assessment
“Candidates shouldn’t have significant organ disease, such as heart disease,” Dr. Kwon says.
“Eligibility is a complicated question. If a person wants to donate, they should come to us so we can determine if they’re healthy enough to donate.”
A transplant may be delayed for the donor to make lifestyle changes, such as losing weight or quitting smoking, to optimize the outcome. Keck Medicine offers a donor wellness program that provides support from dietitians, lifestyle therapists and personal trainers.
There must also be a compatible blood match between donor and recipient. If you want to donate but your blood types don’t match, Keck Medicine has an internal donor exchange program, and it works with a national paired donation program, as well as the National Kidney Registry.
For recipients, “we can find a matching organ from a different donor,” Dr. Kwon says, adding that partnering with other medical institutions is also normal. “There are many other pairs throughout the country whose blood types don’t match. We can organize swaps and make it happen.”
What if I change my mind about organ donation?
Living-organ donation is 100% voluntary. At Keck Medicine, independent living-donor advocates are on hand to ensure donors do not feel pressured or guilted into the procedure. Each donor also has a dedicated medical team that’s independent of the recipient’s care team.
“Even at the very last minute, right before transplant, living donors can still change their minds — and that’s OK,” Dr. Kwon says.
Although living-donor transplants have high success rates and are generally safe, no surgery is without risk, Dr. Kwon says, adding that potential donors are thoroughly educated about the risks and benefits from transplantation, right from the start.
“Many of them decide to go through with it, because they want to see their loved one get better,” Dr. Kwon says. “But donors always have the option to back out.”
How long is the recovery after donating an organ?
Living-donor kidney surgeries take about 3 hours to complete, and donors usually spend 1 to 3 days in the hospital after surgery. Living-donor liver surgeries are longer, taking between 6 to 12 hours, and donors can expect to spend up to a week in the hospital.
“Like any abdominal surgery, recovery after a kidney or liver donation takes about 6 weeks,” Dr. Kwon says. “Donors will feel more tired than usual, as their bodies heal, and we tell them to avoid heavy physical activity for a few weeks. But most people feel completely normal again 2 to 3 months after the surgery.”
The USC Transplant Institute specializes in minimally invasive techniques. Thanks to advancements in laparoscopic surgery, donors can expect to have only a small scar at the incision site.
Dr. Kwon says there is no loss of function associated with a liver donation, and donors can expect their livers to fully regenerate within 2 months after surgery. People can also function normally with just one kidney.
The risk of a donor developing kidney failure later in life is less than 1%, Dr. Kwon says. High blood pressure, diabetes, kidney stones, cancer or traumatic injury can increase the risk of kidney failure, so it’s important for a donor to maintain a healthy lifestyle.
What are the health benefits of organs from living donors?
One of the reasons a person may decide to become a living organ donor is because of the benefits to their loved one.
Patients who receive organs from living donors experience important postsurgical benefits, such as immediate organ function, decreased risk of rejection and increased longevity of the organ.
Timing is the primary reason. Patients usually have to wait several years for an organ — if they receive one at all — meaning they are generally much sicker by the time the transplantation surgery takes place.
According to the U.S. Department of Health and Human Services, more than 100,000 patients are on the transplant waiting list. A new patient is added to the list about every 10 minutes.
With a living donor, “everything is controlled,” Dr. Kwon says. “We can do the surgery much sooner, before the recipient can get sicker. A living-donor donation is the best option for a kidney or liver transplant.”