Organ donation

Having surgery - donating a kidney

After the assessment and approval for living donation, the donors we interviewed had surgery to remove a kidney. Most people went ahead with the operation as scheduled, though Paul and Di said their operations had to be re-scheduled.
With hindsight, Di said she would have liked more information on how donors and recipients are matched. She hadn’t been prepared for the fact that she and a patient that had been lined up for her could be incompatible.
 
Some of the people we spoke to described the pre-operation assessment they had before surgery could take place.
Some of the donors we interviewed had felt nervous leading up to the operation and, for a few, it was the first time they’d had surgery. Clare said she’d felt quite calm on the morning she had to go into hospital but, when she found it difficult to get hold of the specialist nurse, she became anxious. She’d been told to phone the hospital in the morning but, whenever she rang, no one answered the phone. She finally emailed the nurse and went to hospital that evening. Wallee said he asked the nurse for a sleeping pill the night before the operation and then ‘slept like a baby’. On the morning of the operation itself, donors had not been allowed to eat, as with all surgery. Annabel said she’d been worried about having an adverse reaction to general anaesthetic. Di said she’d felt excited as well as slightly nervous, and hoped she wouldn’t panic before having anaesthetic. A few people said their biggest fear was that the kidney would reject.
Some of the people we spoke to said that they were comfortable with hospitals and trusted the doctors and nurses who were caring for them. They’d also been given lots of information beforehand about living donation and the surgery.
Several donors recalled talking with the medical staff just before being anesthetised. Their next memory was of coming round after surgery. Donors are given a general anaesthetic, which means that they are asleep during the operation. Traditionally, the kidney was removed by making an incision in the side or abdomen (tummy), which is known as the ‘open’ technique. This procedure is still used but, increasingly, keyhole surgery is used to remove the kidney and this is also available in a number of transplant centres in the UK. The operation takes approximately two hours and the donor will have a urinary catheter and a drip when s/he returns from theatre.
 
Donors described how they felt when they first came round after surgery. Some felt a bit disorientated at first and several mentioned being attached to a drip and having a catheter. Some donors said they were in pain at first but were given good pain relief, which they could administer themselves. Strong pain relief, often morphine, is given to help alleviate pain and discomfort after the operation. Darren was in quite a lot of pain and turned out to have had a complication, which meant him staying in hospital longer than he’d expected.
A few people said they’d reacted to the morphine they’d been given for pain relief and this had made them sick. Doctors gave them other painkillers instead, as well as anti-sickness medication. One woman said the morphine she’d been given had made her feel very itchy and so her pain medication was changed.
Some people said they’d had little appetite at first. Others were able to eat and a couple of people said they’d enjoyed the food. After the catheter had been removed, they’d been encouraged to try and walk but had found walking painful or sore. They walked very slowly and carefully to begin with and needed help going to the toilet. Gradually, walking became slightly easier. Several mentioned that the nurses were helpful and caring, though a few people felt that the day nurses had been more helpful or friendlier than the night staff. Most praised the care they’d received from doctors and nurses and had faith in the team looking after them.
Nurses came round to check on donors regularly. Several also said that it had been helpful having the company of visitors or talking to other patients on the ward. When they were allowed, those who’d donated a kidney to a relative or friend went to see how the recipient was feeling. Those who had donated to an anonymous recipient were told by the doctor, shortly after coming round, that the transplant had been successful (see The recipient). There is no guarantee that any kidney transplant will work. However, living kidney transplantation is overwhelmingly successful with 96% of live donated kidneys working well at one year. This compares with a success rate of 93% for kidneys from deceased donors.
Some of the people we talked to said they didn’t sleep very well in hospital as the ward was noisy or because they were constantly being monitored. One person said the bright lights on the ward prevented him from sleeping well. Some people had their own room and had found this helpful. Several had looked forward to being discharged so they could sleep and recover in their own environment. How long a donor spends in hospital varies and depends on individual recovery. The average stay is three to seven days. Donors were discharged from hospital with painkillers to take during their recovery (see Recovery at home and follow up’).
 
The people we interviewed had felt confident that donating a kidney was the right thing to do and had felt assured that the risk to their own health was low. All of them recovered well and encouraged other people to think about living donation. All operations carry some risk and this is no different for living donation. Donors are at risk of infections (e.g. chest, wound or urine) and, more rarely, bleeding or blood clots. There is a very small risk of death for the donor, and it is estimated at 1 in 3000 for this operation (NHS Blood and Transplant 2015).

Last reviewed May 2016.
Last updated May 2016.

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