NewYork-Presbyterian Transplant Institute has a very active living donor program, that enables a person with end-stage renal disease to receive a donor kidney from a relative, spouse, or friend – a truly wonderful and generous gift.


Presurgical Evaluation for Living Donors

If you are interested in becoming a living donor, you will be medically evaluated at one of the Institute's two outpatient centers – the Beverly & Arthur Shorin Comprehensive Transplant Center at NewYork-Presbyterian/Columbia or the Rogosin Institute David D. Thompson Outpatient Center, which is affiliated with NewYork-Presbyterian/Weill Cornell – depending on where your recipient will have the transplantation surgery. Ideally, it would be best if you join your prospective recipient at his or her first appointment so you can immediately begin your medical evaluation process. Remember to inform the center that you will be coming so testing can begin.

You will be evaluated by a separate group of nephrologists, physicians, surgeons, psychiatrists and social workers to avoid any conflict of interest. During the comprehensive evaluation process, you also will receive information that will enable you to make an informed decision without being pressured by the physicians and surgeons caring for the recipient.

Your blood will be drawn for testing to determine if your kidney will be a compatible match with your family member or friend needing the new organ. If you are considered a compatible match, you will be examined by a nephrologist, who, along with a surgeon, will be your primary caregiver.

You also will meet with other members of your transplant team – a nurse coordinator, a social worker and a financial counselor. Throughout the presurgical evaluation, you will learn what it means to be a donor including the specifics of the surgery and recovery. The recipient's health insurance covers your medical expenses from presurgical evaluation through surgery and follow-up. There will be no medical expenses billed to you. However, non-medical expenses, such as travel, generally are not covered by the medical center or the recipient's insurance and need to be discussed with the financial counselor.

Once it has been established that your kidney is a match with the recipient, you will be medically tested to ensure that you are healthy enough for the surgery and that both your kidneys are functioning well. Certain medical problems, such hypertension or diabetes as well as any medical conditions that may increase the usual risks of surgery, will rule you out as a potential donor. The tests include, but may not be limited to:

• Comprehensive urine and blood tests
• Blood glucose test for diabetes
• Electrocardiogram
• Chest x-ray
• CT angiogram, which may include a renal scan, to reveal the function and structure of the kidneys. This test provides the surgeon with a "roadmap" of the kidneys' anatomy- their size, function, veins, and arteries. Whenever possible, the left kidney is donated because it has longer veins and arteries, which make attaching the organ to the recipient easier.
• Evaluation by social worker and psychiatrist on team.

Certain tests, including some of the preliminary blood work, can be performed by your own physician. At the conclusion of the medical evaluation, your transplant team will determine your suitability to safely donate your kidney. Your nurse coordinator then will notify you about the team's decision. If you have any concerns with being a living donor, we encourage you to discuss them with any member of your donor transplant team. It is very important that you are comfortable with your decision. For most living donors, this extraordinary experience of giving a kidney – a gift of health – is a very positive one.


A Special Donor Exchange Program

Usually, a living donor is a spouse, friend or relative of the recipient. But there are times when intention is not enough. If two renal patients at the NewYork-Presbyterian Transplant Institute prove to be incompatible with their loved ones – but would be compatible with a potential donor of the other patient – the Institute may be able to arrange a unique exchange program. The donors would switch places for simultaneous transplantation surgeries


Laparoscopic Surgery – Breakthrough Technique

The living donor surgery at the NewYork-Presbyterian Transplant Institute is performed laparoscopically in all but a very few cases. It is a minimally invasive procedure, which will allow you to recover faster and experience less post-operative pain than you would with the standard open surgery.

While you are under general anesthesia, your surgeon will make two small puncture holes in your abdomen one to insert a tiny flexible videoscope, which projects the image of your organs onto a television screen, and the other to insert the instruments necessary to perform the surgery. The kidney is removed through a two- to three-inch incision below the navel compared with the much larger incision used in standard operations.

Your surgeon will hand your kidney over to the recipient's surgeon, who will immediately cool it by flushing it with a preservation solution. This helps the kidney stay healthy during transfer between the adjoining operating rooms.

Following surgery, you will go to a recovery room and then to a special transplant unit where you will stay two or three days. Within two weeks of your discharge, you will be seen by your surgeon and then return to the care of your own physician. Within two weeks following the surgery, you will be able to return to work and resume your normal daily activities. And you will be able to begin strenuous physical activities within a month or six weeks. You should have your kidney function and blood pressure checked at the transplant center or by your own physician six months following surgery and annually thereafter.