Living Donor Program Contents
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- History of Living Donation
- Living Donor Kidney Program
- Kidney Donor Resources
- Living Donor Liver Program
- Our Care Team
Live donation allows patients to receive a transplant without waiting for an organ from a deceased donor. The Massachusetts General Hospital Transplant Center has one of the most active and experienced living kidney and liver donor programs in the region, as well as the largest, and performed the most deceased and living donor kidney transplants in 2019.
Explore the History of Living Donation
- First successful kidney transplant between identical twin brothers at Peter Brigham Hospital, now known as Brigham and Women’s Hospital
- First successful living kidney donation happened in Boston when a living donor gave a kidney to his identical twin
First successful liver transplant
First successful heart transplant in United States
First successful lung transplants
National Organ Transplant Act is passed, prohibiting the selling of organs and establishing the Organ Procurement and Transplantation Network to ensure the fair and equitable allocation of donated organs
First successful living donor liver transplant
First successful living donor lung transplant
Coalition on Donation (later renamed Donate Life America) founded
First living donor kidney removed by laparoscopic surgical method
April designated as annual National Donate Life Month
Living Donor Kidney Program
Donating a kidney to another individual is an act of great kindness. Nearly half of the kidneys transplanted at Mass General are given by living donors—family members, friends, co-workers and donors who are unknown to the recipient.
There are several benefits to receiving an organ through living donation, as well as becoming a living donor.
Benefits for Recipients
- It is quicker than waiting to receive an organ through the deceased donor waitlist
- It reduces time spent on dialysis
- There is immediate impact, as a kidney from a living donor usually functions right away and, on average, lasts longer than a deceased donor kidney
- There is more comprehensive knowledge of the donor and their lifestyle
- Along with the donor, you pick the surgery date that works best for your schedule
- Your choice to receive an organ through a living donor subsequently shortens the time others in need of an organ have to wait on the deceased donor waitlist
Benefits for Donors
- Many donors have described this process as being a positive emotional experience
- It results in more time with your loved one(s)
- If you donate through the National Kidney Registry, your gift goes even farther and can enable multiple transplants
- Along with the recipient, you pick the surgery date that works best for your schedule
- Your choice to be a living donor subsequently shortens the time others in need of an organ have to wait on the deceased donor waitlist
Patients who choose to undergo a kidney transplant may have identified a living donor who is willing to donate a kidney. Even in cases where the donor is incompatible with the recipient, our active living donor transplant program can match patients with compatible living donors through the UNOS Paired Kidney Exchange Program or the National Kidney Registry (NKR).
Why Choose Mass General
At Mass General, we are proud to be the largest living donor kidney transplant program in the region, as well as the largest kidney exchange program for those who do not match with their intended recipient. A dedicated team of coordinators and surgeons guide the donors throughout the process and value donor candidates' time. All initial consultations start remotely and candidates will be invited for a physical evaluation at Mass General if the records and results are favorable.
We offer advanced donation and remote donation. In fact, Mass General was the first center in the country to receive a remote kidney donation, when a kidney was donated in San Diego and given to a recipient in Boston.
We offer a robust telemedicine platform to allow for remote follow-up after surgery and strive to discharge patients after surgery as soon as it’s safe and the donor is comfortable—it could be as early as the day after surgery.
The Process to Become a Living Donor Kidney
Individuals who wish to become living donors undergo a three-part evaluation process. Our dedicated donor coordinators guide potential donors through each step, keeping them informed of testing and evaluation results. Typically, the recipient's insurance will cover the cost of the evaluation and surgery.
Phase One: Living Donor Health Questionnaire
- Donor evaluation begins with the prospective donor submitting a completed living donor health questionnaire to determine their overall health status and candidacy to donate
- Once a completed living donor health questionnaire is received, the donor will receive a confirmation email with further instructions
Phase Two: Multidisciplinary Team Evaluation (Part 1)
- The donor candidate will complete lab work (blood and urine, including a 24-hour urine collection) at a local lab. Once the donor team receives the results, and if they do not find any serious abnormalities, the donor candidate can be scheduled for an appointment(s)
- Candidates come to Mass General for a half-day donor evaluation visit. This visit includes an educational session, a meeting with the donor coordinator, social worker and a nephrologist (a doctor who specializes in kidney care), who reviews the candidate’s medical history and conducts a physical examination
- The physical examination includes an electrocardiogram (EKG) and chest x-ray
- Based on the medical history and physical exam, other tests may be necessary and can often be scheduled close to the candidate’s home
Phase Three: Multidisciplinary Team Evaluation (Part 2)
- The donor candidate returns to Mass General for a computed tomography (CT) scan of the kidneys and blood vessels, as well as any other necessary appointments or tests (depending on scheduling availability)
- This visit includes meeting with the surgeon to discuss the candidate’s ability to donate, as well as the surgical procedure and hospital experience
- The donor candidate also meets with the independent donor advocate, who works with the donor candidate to ensure that his or her best interests are represented and that decisions made are to the benefit of the donor
Once all tests are complete, the donor’s candidacy is reviewed at the Mass General Transplant Center’s multidisciplinary kidney transplant selection meeting. If the donor is approved, donation surgery can be scheduled on a date that is convenient for both the donor and recipient, or the donor can begin the process of being entered into the paired exchange.
Kidney Donor Resources
The Mass General Transplant Center actively participates in many donor support and advocacy initiatives. We are a chartered member of WELD (WoMen Encouraging Living Donation), which is a network of living donor advocate. We also partner regularly on education and outreach initiatives, as well as organize regular donor forums. With these forums, we bring together Mass General donors to foster opportunities for education and community building and to ensure continuation of relationships following donation.
Q. What if I am not a compatible donor?
Mass General participates in the National Kidney Registry (NKR), an independent organization that facilitates transplants for patients with incompatible living donors as well as for antibody, blood type, size and age issues. A computer program finds suitable donors from other mismatched pairs in the NKR, and identifies the necessary exchanges needed to allow all corresponding recipients to be transplanted from a suitable donor. Patients may be part of a multi-pair chain that results in several recipients being transplanted across many states.
Mass General can register patients with incompatible living donors in the UNOS Paired Kidney Exchange Program, which works to expedite transplants in patients with blood group antibodies or other incompatibilities to their potential living donors.
Q. What are the financial implications of becoming a donor?
Donor evaluation testing, appointments and the surgery itself are covered by the recipient's insurance—this does not include any preventative screening costs, travel and accommodation expenses or parking costs; however, we can provide resources that may help with these types of extra expenses. The National Living Donor Assistance Center's (NLDAC) mission is to reduce the financial disincentives to living organ donation. They operate a nationwide system that provides reimbursement of travel and subsistence expenses to people being evaluated for and/or undergoing living organ donation.
Donor Shield is a donor protection program run by the NKR. The Donor Shield Program Centers' offerings include reimbursement of lost wage and travel, offered to Mass General living donors who participate in an NKR swap.
Living Donor Liver Program
Mass General has one of the most active and experienced living donor liver transplant programs in New England. Through living donor liver transplantation, a family member or friend donates a portion of his/her liver, allowing patients to receive a transplant without a prolonged waiting period. The donor’s healthy liver grows back to full size within a few weeks.
Donating a portion of your liver to another individual is a great act of kindness and can be life-saving for the recipient. A liver transplant is a complex surgery for both the donor and the recipient. In order to effectively plan for the surgery and ensure the best possible outcomes, the Mass General liver transplant team evaluates living donors in a three-part process. Potential donors may choose to discontinue their evaluation at any point in the process, for any reason, with complete confidentiality. Typically, the Transplant Center and the recipient's insurance will cover the cost of the evaluation and surgery.
The Process to Become a Living Donor
Phase One: Questionnaire and Blood Tests
- Donors must be between the ages of 18 and 55, and have no serious medical problems
- The donor evaluation begins with the potential donor contacting our transplant center and answering a few questions that allow us to determine the donor’s overall health status
- Standard blood tests will be done to determine blood type, liver function and overall health status. Blood testing can be performed at Mass General or at another local hospital
Phase Two: Team Evaluation and Surgeon Visit
- The donor will meet with our hepatologist (a doctor who specializes in the treatment of the liver, gallbladder, biliary tree and pancreas), living donor nurse coordinator, financial coordinator, social worker, living donor advocate and nutritionist to learn about the donation process and to ask any questions
- The evaluation includes a complete medial history and physical examination, and additional testing such as an electrocardiogram (EKG), chest X-ray, a CT scan of the abdomen to evaluate liver anatomy and other blood work or tests as needed
- Next, the donor will meet with a surgeon from the Mass General Liver Transplant Program to discuss the surgical procedure and hospital stay. The operation is performed using a laparoscopic-assisted technique, and the majority of donors go home five to seven days after surgery
Phase Three: Anesthesia Evaluation and Scheduling Surgery
- Once all tests are complete, the transplant team will discuss the donor's eligibility at our weekly multidisciplinary liver transplant meeting to determine if the donor is approved for surgery. Once approved, we will schedule the surgery on a date that is convenient for both the donor and recipient
- The donor will meet with his/her surgeon to sign the surgical consent form and to answer any last-minute questions. The donor will also meet with an anesthesiologist to discuss the anesthesia process and answer any additional questions
Our Care Team
Associate Medical Director: Kassem Safa, MD
Surgical Director: Nahel Elias, MD
Living Donor Nurse Coordinators:
- Elizabeth Gigliotti RN, CCTN
- Kelly Herdman RN, BSN
- Melissa Rosenthall, RN, BSN
Independent Living Donor Advocate: Judy Burrows, MSW, LICSW
Patient Service Coordinator: Kenzie Langton