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Why do living donor kidney transplants offer better outcomes?

Living donor kidney donations offer a number of advantages for the recipient of an organ transplant. We asked University of Minnesota Health Transplant Surgeon Ty Dunn, MD, to tell us more.
Living donor kidney transplants generally offer better outcomes for recipients. Why? To find out, we asked University of Minnesota Health Transplant Surgeon Ty Dunn, MD.

In July 2017, more than 97,000 people were waiting for a kidney transplant in the United States, according to the United Network for Organ Sharing (UNOS).

Because of this staggering number, many people in need of a new kidney wait longer for an available donor—and often get sicker while they wait. One solution? A living donor kidney transplant.

Kidney transplants from living donors generally offer better outcomes for recipients and are key to reducing the time patients spend on organ transplant wait lists. But why are they better? We talked with Transplant Surgeon Ty Dunn, MD, to understand why kidneys from living donors are better for recipients and for public health.

Living donor kidneys are generally healthier.

One of the primary advantages to receiving a kidney from a living donor is that the organ is generally healthier. In order to donate, donors are evaluated for their kidney function, compatibility and overall physical/mental health. The cost of evaluation and donation is covered by the recipient’s insurance. Only candidates who test well are approved to become living donors.

Kidneys from deceased donors may be stressed and usually spend a longer time in a cold preservation solution while they’re being transferred between hospitals, Dunn said. This can temporarily reduce organ function. Roughly one-third of kidneys from deceased donors take days or weeks to become fully functional after the transplant, which prolongs the need for dialysis and makes the recipients more vulnerable to complications after surgery. Kidneys from living donors tend to function immediately, reducing the risk of needing any dialysis after transplant to less than 4 percent, Dunn said.

“Receiving a kidney from a living donor means receiving the healthiest organ possible,” Dunn said. “This sets up the recipient for the best short- and long-term outcomes.”

Learn more about our living donor kidney transplant programs.

Living donor surgeries can be scheduled in advance.

The ability to schedule a kidney transplant surgery in advance can make a big difference for both the donor and the recipient. Scheduling ensures that the living donor can plan time off work and for family care. For the recipient, scheduling ensures that the transplant takes place at an optimal time—ideally before the recipient needs to begin dialysis. Patients who avoid dialysis altogether—or only receive dialysis for a short period of time—tend to experience better health outcomes.

The same convenience is not possible during deceased donor transplants, which cannot be planned and occur as emergency procedures whenever a donor kidney becomes available. The waiting time for a deceased donor kidney is typically 4-6 years.

“If you’re waiting for a long time to receive a deceased donor kidney, you’re at higher risk of other health complications that could affect the success of your transplant—or your ability to even get a transplant,” Dunn said.

Living donor transplants reduce wait times.

Due to the long wait list for a new kidney, many people waiting for a kidney transplant will become very sick before they receive an organ. Some patients may even become too sick to go forward with a transplant when an organ eventually becomes available. Approximately 20 people die every day waiting for an organ transplant of any kind, according to UNOS.

Learn more about University of Minnesota Health Transplant Center.

Living donor kidney donation expands the donor pool—and has lasting results.

Living donor kidney donations also expand the donor pool. Every living donor transplant that occurs removes one person from the transplant waiting list, and ensures that the next person on the list won’t have to wait as long for a deceased donor transplant.

Also, living donor kidneys tend to have greater longevity than those transplanted from a deceased donor. A living donor kidney functions on average for roughly 14 years, compared to 10 years for a kidney from a deceased donor.

However, if a recipient makes it through their first year following a living donor kidney transplant without any major complications, doctors expect the kidney to last for about 20 years on average, Dunn said.

“The better people do with their first transplant, the less likely they are to need another transplant,” Dunn said. “That, in turn, makes more kidneys available to more people. Living kidney donors are life savers—not only for the recipient, but for others on the wait list.”