A donor nephrectomy is a surgical procedure to remove a healthy kidney from a living donor for transplant into a person whose kidneys no longer function properly.
The kidneys are two bean-shaped organs located on each side of the spine just below the rib cage. Each one is about the size of a fist. The kidneys' main function is to filter and remove excess waste, minerals and fluid from the blood by producing urine.
People with end-stage renal disease need to have waste removed from their bloodstream through a machine (hemodialysis), via a procedure to filter the blood (peritoneal dialysis), or via a kidney transplant.
Living-donor kidney transplant is an alternative to deceased-donor kidney transplant. A living donor can donate one of his or her two kidneys, and the remaining kidney is able to perform the necessary functions.
You may choose to donate your kidney in one of two ways:
Donor nephrectomy carries certain risks associated with the surgery itself, the remaining organ function and the psychological aspects involved with donating an organ.
For the kidney recipient, the risk of transplant surgery is usually low because it is a potentially lifesaving procedure. But kidney donation surgery can expose a healthy person to the risk of and recovery from unnecessary major surgery.
Immediate, surgery-related risks of donor nephrectomy include:
Once you've gone through the living organ donor screening, evaluation and informed consent process, your donor nephrectomy procedure will be scheduled for the same day as the transplant surgery for the recipient. Separate medical teams and surgeons normally perform the donor nephrectomy transplant surgery, but they work closely together.
You'll receive instructions about what to do the day before and the day of your kidney donation surgery. Make note of any questions you might have, such as:
Donor nephrectomy is performed with general anesthesia. This means you will be asleep during the procedure, which usually lasts two to three hours. The surgical team monitors your heart rate, blood pressure and blood oxygen level throughout the procedure.
Surgeons almost always perform minimally invasive surgery to remove a living-donor's kidney (laparoscopic nephrectomy) for a kidney transplant. Laparoscopic nephrectomy is associated with less scarring, less pain and a shorter recovery time than is traditional open surgery to remove a kidney (open nephrectomy).
In a laparoscopic nephrectomy, the surgeon usually makes two or three very small incisions close to the bellybutton, which are used as portals (ports) to insert the fiber-optic surgical instruments. The equipment includes a small knife, clamps and a special camera called a laparoscope that is used to view the internal organs and guide the surgeon through the procedure.
A slightly larger incision is made below the bellybutton to remove the donor kidney.
In open nephrectomy, a 5- to 7-inch (13- to 18-centimeter) incision is made on the side of the chest and upper abdomen. A surgical instrument called a retractor is often used to spread the ribs to access the donor's kidney.