Living Donor Kidney Surgery
As a donor, before you actually undergo transplant surgery, you will have a pre-surgery visit with the Kidney Transplant Team. The pre-surgery visit is four to five days before surgery.
At this visit, we will complete your pre-surgery evaluation and testing and review the surgical consent forms. You will also get instructions for the day of surgery, including when and where to arrive. By completing these items in advance, we hope the day of surgery is less stressful for you.
Expect the following during the pre-surgery visit:
- Basic lab work
- Chest X-ray
- Crossmatch (final), mixing the recipient’s blood with yours to see if each person’s antibodies will react
- Physical exam
- Sign the surgical consent form. The doctor will explain the surgical consent to you in detail before you sign.
Morning of Surgery
You will arrive at the hospital early on the day of surgery and meet your anesthesiologist. The nurses in the pre-operative unit will prepare you for surgery. They will place a peripheral IV in your arm to allow medications and fluids to be given during and after surgery. You will be taken to the operating room where general anesthesia will be administered and the surgery will take place. A urinary catheter will be placed in your bladder after you are asleep.
Removing the Living Donor Kidney
The living donor kidney is removed during a minimally invasive procedure called laparoscopic kidney removal.
First, the abdomen is inflated with gas, which creates a space between the wall of the abdomen and the organs inside. The surgeon will then make three small punctures totaling no more than a half-inch long. Small instruments are inserted through these punctures to free up the kidney and tie off the blood vessels.
A video camera is attached to one of the instruments inserted into the abdomen. The camera transmits a picture to a video monitor, which allows the surgeon to view the inside of the abdomen while performing the surgery.
The kidney is removed through a short incision, approximately 2.5 inches long. The kidney is placed on ice and immediately taken to the recipient’s operating room. The recipient is already asleep, and his or her blood vessels are exposed to allow the surgeons to implant the kidney right away.
There are several advantages to laparoscopic kidney removal:
- It minimizes the trauma to internal organs.
- It avoids a long incision through the muscles, eliminating most post-operative problems.
- Post-operative pain is significantly reduced, which encourages quicker recovery by allowing the donor to breathe, cough, and walk with less discomfort.
- The need for strong pain medications is significantly reduced, minimizing drowsiness and unsteadiness.
- Hospital stays are reduced. Most donors are able to leave the hospital 24 to 48 hours after surgery.
It is normal for a donor to have fears and concerns about potential surgical complications. The risks associated with laparoscopic kidney removal are usually very small and manageable. Potential donors will have the opportunity to discuss the surgical risks in detail with the transplant surgeons during their evaluation.