Organ donation

Recovery at home and follow up after living donor kidney transplantation

Patients who have had surgery to donate a kidney are given painkillers immediately after the operation and when they are discharged from hospital, to use during their recovery period. Some people may also be prescribed antibiotics for a short period if they need them. However, living donors do not need any long-term medication as a result of kidney donation.

Many of the people we spoke to talked about coming back home from hospital and recovering from their operation. Recovery can take between two to twelve weeks, depending on surgery, individual recovery and the type of work a donor will be resuming. Donors need to rest after being discharged from hospital. They also need help during the first week or two if they have children or elderly parents to care for and with day-to-day domestic tasks.
 
The first few days back home, the donors we interviewed said they’d rested, slept, took it easy or just ‘pottered around’. They had been discharged from hospital with painkillers, usually paracetamol, sometimes also codeine. Several mentioned having discomfort or pain around their wound. Some found getting out of bed particularly painful. One woman said the painkillers she’d been prescribed hadn’t been strong enough, so her husband visited her GP who prescribed her something stronger. Many of those we interviewed felt unusually tired during the first week. Several said they’d had no or little appetite at first, though this improved over time. A few people felt constipated or had indigestion. Donors were careful not to lift anything heavy or over-exert themselves physically and had been advised not to drive. They managed to walk but at first very slowly and carefully. One woman was concerned about the dark colour of her urine when she first came back home but said this soon went back to normal.
During the first week, most people received support from family or friends, several saying it was helpful to have someone there to cook meals and do the shopping. Darren stayed with his girlfriend for a few days. Di praised the support she got from her ex-husband. Her son lived nearby, and it was reassuring to know she could phone him if she needed anything. Clare said she had a lot of support from friends but sometimes found it draining having company when all she wanted was rest. She advised people with dogs to arrange dog-walking in the first week. Clare said she had used the opportunity of being off work to get some building work done at home, but that it hadn’t been a good idea. The drilling was noisy and all she’d wanted was sleep. Other people said their feelings of tiredness wore off quite quickly and they started doing light things after a few days.
Wallee travelled from England to Holland to donate a kidney to a friend. His first week back to a friend’s house felt isolated because all of the other house-mates were on holiday.
The recovery time varied and depended, in part, on the time donors felt able to take off work and whether they had manual or non-manual jobs. Most of the people we interviewed started feeling a bit stronger in the second week and made good progress from there on. Some people said they started driving again after two weeks, though only on short journeys. Paul, a GP, went back to work after two weeks, though his first week back was ‘gentler’ than normal. Many people had started feeling a lot better after the first couple of weeks, though were still careful not to over-do it. Darren worked in a physically demanding job and said he planned to take two or three months off work because he didn’t want to take any risks with his health (see ‘Work and finances). Di, who wasn’t working at the time of interview, said she was particularly cautious. If the doctors recommended a week, she took two. Several said that their scars had healed gradually and, over time, were no longer uncomfortable, very small or hardly visible.
 
Maggie said she went back to work after seven weeks. She felt her recovery might have been slower than that of other donors because of the minor complications she’d had. She also worked in a demanding teaching job and didn’t want to go back too soon.  
    
A few people said that their time spent at home to recover had allowed them to slow down for the first time in ages, and they’d appreciated life at a slower pace. Wallee said it had given him time to read and watch some films. Clare said she thought she’d be bored doing nothing but no longer worried about retirement as she realised she’d have plenty to do.
 
All the living donors we interviewed recovered well and had no regrets about donating a kidney. Many said that, quite unexpectedly, they had gained enormously from the experience and that there had been ‘no downsides whatsoever’ (see Feelings about donating a kidney). Annabel said she had a very small hernia because of the surgery, but nothing that caused her any concerns. Harmanjit (Interview 38) said she had some adhesions after surgery but they too were nothing serious or worrying.
Follow up
 
Living donors are seen by the transplant team between two and six weeks after donation, and are recommended to attend an annual follow-up appointment for the rest of their lives. There is a small possibility of a slight rise in blood pressure and excess protein in a donor’s urine after donating a kidney. None of the donors we interviewed had had any problems relating to the donation. Studies have shown that there is no long-term effect on the health of the donor or their remaining kidney. Studies have also shown that donors tend to live longer than the average population. This is probably because they are selected on the basis of good health and are thoroughly screened before donation.

Donating a kidney does not mean that the donor’s health might not be affected in some way in the future. It is always possible that something unexpected could happen to the remaining kidney. As the health of all donors is thoroughly assessed before donating, the chances of this are very small, especially if the donor has a generally healthy lifestyle after donation. In the unlikely event that a problem occurs with the remaining kidney, dialysis treatment may be needed earlier than if the person had both kidneys.   

“The overall risk of developing ESRD (End Stage Renal Disease) after kidney donation remains very low, occurring in less than one in 200 (0.5%) donors, and it remains much less than that of the general (unscreened) population.” (Addendum to the UK Guidelines for Living Donor Kidney Transplantation -November 2015*)
 
Most people we spoke with had their first follow up appointment shortly after surgery, another after 6 months and then had annual check-ups after that. Several mentioned that they appreciated having their kidney function checked and that attending a yearly appointment was easy and convenient. Most people had their check-ups at a local hospital or at their GP surgery so did not usually return to the hospital where they had had their operation.


Last reviewed May 2016.
Last updated May 2016.

*References
  1. Muzaale AD, Massie A, Wang M-C, et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014; 311: 579-86.
  2. Mjøen G, Hallan S, Hartmann A, et al. Long-term risks for kidney donors. Kidney Int 2014; 86: 162-7.

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