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Department for Nephrology

Nephrology

Living kidney donation / living kidney transplantation

Living kidney donation is the donation of a kidney from a healthy person for transplantation. This is in contrast to post-mortem kidney donation, in which the kidney of a deceased person is transplanted. In Germany, around 1400 kidneys are currently transplanted from deceased patients every year. The actual need is much higher. As a result, dialysis patients on the transplant waiting list have to wait an average of eight years for a kidney transplant. This means a long wait for haemodialysis or peritoneal dialysis and the progression of complications.

A Living kidney donation can significantly improve this situation. If a living donor kidney is donated before the recipient has to go on dialysis (a so-called pre-emptive transplant), the patient can be spared the period of dialysis with all its restrictions and subsequent complications. If this is no longer possible, the dialysis time is at least significantly reduced. The Regensburg University Hospital currently performs 10 to 15 live kidney transplants every year. Transplantation with different blood groups between donor and recipient (ABO incompatible kidney transplantation) has also been standard practice at the Regensburg University Hospital for many years.

  • Requirements

    Every living kidney donation must meet a number of different requirements set out in the German Transplantation Act (Transplantationsgesetz, TPG) and the guidelines of the German Medical Association (Bundesärztekammer). The donation must be voluntary and reflect a close emotional bond between donor and recipient. According to §8 TPG, only first- or second-degree relatives, spouses, registered partners, fiancés or other persons who are obviously close to the recipient in a special personal relationship may donate a kidney in Germany. These requirements are examined and assessed in two outpatient appointments by an independent "Living Donor Commission" of the Bavarian Medical Association. In addition, a potential donor must be in very good physical health with no significant pre-existing illnesses and have above-average kidney function. In addition, certain requirements for tissue compatibility between donor and recipient have to be checked.

  • Information session

    The potential donor and the recipient are informed about the opportunities and risks of living kidney donation in a one-hour information session. This discussion is usually held at the same time as the information session about joining the waiting list for a post-mortem kidney transplant - a prerequisite for living donation. The purpose of the consultation is to provide comprehensive information and, of course, there is no obligation to undergo further tests or to agree to a living donation. In order to be able to assess the suitability of the potential donor at this stage, the potential donor must have a number of tests carried out beforehand and bring these with them to the interview.

  • Inpatient assessment of living donor suitability

    If, after the initial assessment, a living donation appears to be possible, the potential donor is admitted for a three- to four-day inpatient stay for a comprehensive clinical and instrumental evaluation (including CT and MRI of the kidneys). The donor's suitability is then assessed by the multidisciplinary transplant conference and the decision is communicated to the donor and the recipient. Preparation for a living kidney donation usually takes three to six months.

  • Living kidney donation

    The donor is admitted to the surgical unit the day before the operation. On the day of the operation, the kidney donation is performed by a team of experienced transplant surgeons using a minimally invasive keyhole (laparoscopic) technique. The operation usually takes two to three hours and the patient stays in hospital for four to six days. Donors then receive lifelong follow-up care in the transplant outpatient clinic of the nephrology department, working with their primary care physicians.