Narrator: Living donation is a wonderful act of generosity and courage. This video will talk about what is involved with donating a kidney. Before you decide to become a kidney donor, you should understand fully what donation involves. If you have any questions about this information, talk with your health care provider. There are many things to learn about and consider before donating your kidney for a transplant.

First off, kidney donation is a major surgery you do not have to have. It requires a commitment between you and Mayo. There are many reasons, several of which are discussed later in this video, of why people may not be able to donate. There are many advantages for the recipient to having a living donor. Transplanted kidneys from living donors usually last longer and work better. Most people experience a shorter waiting time and may be able to avoid dialysis. Another advantage to living donation is that the surgery can be planned.

Your kidneys, which are two bean-shaped organs, each the size of a fist, are amazing organs that do many important jobs in your body. Their main job is filtering waste and excess fluid. Other jobs of your kidneys include keeping you hydrated by controlling how much water is in your body, helping control blood pressure, balancing chemicals, and getting rid of toxins and filtering medications.

Many people are evaluated at Mayo Clinic each year to see if it is an option for them to donate a kidney. Most evaluations take two days and include many appointments with a variety of medical staff. Your evaluation would be separate from the recipient and kept confidential. You may stop the evaluation at any time for any reason. You will have a variety of appointments with several different staff during your visit. You will meet with a kidney doctor, who is called a nephrologist, a surgeon, a living donor advocate, a nurse who will discuss your blood pressure, a social worker, an RN coordinator, and a finance specialist. Each of these individuals will help paint the bigger picture of what donating a kidney entails.

While you are being evaluated at Mayo Clinic, you will have a variety of tests to help determine if kidney donation is a good option. Some of the common tests include a physical exam, blood and urine tests, x-rays, a CT scan, heart and lung function tests, and cancer screening. Other tests may be needed, depending on your situation, and will be ordered by your health-care team.

After your evaluation, your results will be reviewed by the living donor team. At that point, you will either be approved to donate, deferred, which often means more testing needs to be done, or not approved. Reasons why some people are not able to donate a kidney include medical concerns, that the kidney anatomy doesn't match, or psychosocial concerns.

Even if you are approved, you can change your mind at any time. If you want to donate a kidney to a family member or friend, but you are not a good match, you may be able to be part of a paired donation. With this kind of donation, you give your kidney to a person who is a match for you. That person also has a donor who is not a good fit, but who is a match for your friend or family member. Your friend or family member gets a kidney from the other donor. In some cases, more than two pairs of donors and recipients may be part of a paired donation. If you find out you cannot give a kidney to the person you planned to, ask a member of your donor team to see if paired kidney donation may be a choice.

Kidney donation surgery is a major surgery that takes two to four hours. Separate operating rooms are used for you and for the person who is receiving the kidney. During transplant surgery, the surgeon makes an incision below your waistline. Two other small incisions are made for instruments used during surgery. Because there is not one large incision, this is called an assisted laparoscopic surgery. After surgery, expect to be in the hospital for one to three days.

There are many risks associated with having surgery. Some of the common risks include bleeding, possible blood transfusion, blood clots, infection, a reaction to anesthesia, or the possibility of it turning into an open surgery, which has a large incision. Rare complications include future kidney failure, a need for a new kidney, or death.

In the case of you needing a future transplant, according to UNOS policy, you will be given additional points priority on the national waiting list. You would need to meet the same criteria, and having a living donor is also an option. The good news is, most donors do not have long-term problems.

After surgery, you may feel tired and have some pain, but it will get better. To help with your recovery, it is important to attend all follow-up appointments and follow your activity restrictions. You can return to work as you are able, but expect at least two weeks. Most people take one to two months to recover. It is also important to avoid pregnancy for one year.

After you leave the hospital, it is recommended to stay near Mayo Clinic for two to three days. Expect to follow up with Mayo Clinic for at least two years. Most people have appointments at six months, one year, and two years after surgery.

There are many costs to consider in making the decision to donate your kidney. The main costs, such as your evaluation, surgery, and follow-up appointments, are billed to your recipient's insurance. However, if a medical problem is found during your evaluation, treatment for that problem would need to be covered by you or your insurance. There are other expenses for you to think about, such as travel, lodging, and lost wages while you are recovering. Some people also need to consider day care or other additional care services, such as boarding for pets.

It is illegal to be paid to be a donor. Many people decide not to donate for a variety of reasons. If you choose not to donate, your evaluation ends at that time. Your decision is kept confidential from the recipient. Remember, the recipient always has other options.

There are many resources you can tap into while making your decision. You can call the UNOS service line with many of your questions. You may also message your Mayo Clinic care team through Mayo Clinic Online Services. Ask your living donor coordinator for more educational resources if you need them. You can also call your coordinator during regular business hours.

Remember, you may stop this process at any time. Kidney donation is a major surgery you do not have to have. It does require a lifelong commitment to follow-up care. Thank you for taking the first step in exploring kidney donation.