Risks and Costs of Kidney Donation

Let's talk about the risks of donating a kidney, because yes, there are some. Some people make their decision about donating easily, with no concerns about risks. But if you're considering donating a kidney, you may be running through the same list of what-ifs that many donors run through:

• What if my spouse (kids, sibling, parent, cousin, best friend) need a kidney?

• What if I develop kidney disease or some other health problem that causes my remaining kidney to fail?

• What if there's a complication with surgery?

They're all legitimate questions. You need to talk them through with your family and transplant team, weigh the facts, and decide if they're deal breakers for you. 

There's one other what-if that's often the one that helped donors make their decision: What if none of those potential risks happen?

Risks of Surgery

Donating a kidney involves major surgery, so it comes with risks, like all surgeries do. Those risks can include:

• Pain

• Infection

• Blood loss

• Blood clots

• Reaction to anesthesia

• Pneumonia

It's rare and the risk is tiny, but there is a risk of death in surgery, like all major surgeries. A study found that risk to be about the same as a pregnancy-related death—3.1 in 10,000, or 1.3 in 10,000 if you don't have high blood pressure. 

Most complications from surgery aren't critical, but may mean a longer hospital stay. The medical team caring for you specializes in transplant surgery. They know the type of conditions that can lead to complications, know what to watch for and how to treat them if they develop. They don't want risks or complications to develop any more than you do.   

Living With One Kidney

It makes sense to ask, if we're born with two kidneys, how can we live normally with one? It's another one of those wonders of how the human body adapts and compensates when it needs to. When you donate a kidney, cells in the remaining kidney enlarge to handle the filtration and work that two did before. 

Obviously, when you give away a healthy kidney, keeping your remaining kidney healthy becomes a priority. Long term, donating a kidney has minimal risks on your overall health. Kidney donors have a slight increased risk for developing high blood pressure and women who become pregnant after donating have a slight increased risk of developing preeclampsia.

Research has shown that donating a kidney doesn't change your life expectancy. You do have a slight increase in risk for developing kidney failure—less than one percent—and if you do, your donation gives you priority status, moving you to the top of the waiting list.   

Paying For the Costs of Living Donation

Who pays the costs of testing, surgery, hospitalization and doctors' services for living donation? Generally, the recipient's Medicare or private insurance. (Anyone with end-stage renal disease and on dialysis is covered by Medicare.) Services and costs donors may be responsible for can include:

• Preventive health exams (mammogram, pap smear, prostate health screening, colonoscopy) you need for the evaluation process that are part of routine health care

• Further testing and treatment for health issues uncovered during your evaluation process

• Annual well-visits with your own doctor

Insurance costs

The Affordable Care Act currently prevents health insurance companies from charging different rates or refusing to cover you because of a pre-existing condition such as kidney donation. Be sure and talk with the transplant team about any changes in the law that may have been made.

Kidney donation shouldn't affect your ability to get or keep life insurance. However, there have been rare cases when kidney donation did have an impact. Transplant teams can provide insurance carriers the current data that show that kidney donation does not affect long-term life expectancy.

Many transplant centers participate in the live donor insurance program offered through the American Foundation for Donation and Transplantation. The National Kidney Registry also offers insurance to donors in the paired exchange program.

Other costs not covered

There are costs you may have that aren't covered by Medicare or the recipient's insurance, including. 

• Lost wages from unpaid time off work

• Child care

• Travel costs, if testing and surgery are out of town

• Lodging (some recipients' private insurance may pay a per diem)

If you have short-term disability through work, it may cover kidney donation. Some states provide a tax credit for donors. The National Living Donor Assistance Center  promotes living donation by helping living donors pay for costs like transportation, lodging and food, that aren't covered. The American Society of Transplantation has a worksheet that can help you look at the possible costs involved with donating a kidney.