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Types of Living Donation

Janet Hiller, RN, MSN, and Sandy Loevner, living kidney donorTransplant nurse Janet Hiller with living kidney donor Sandy Loevner.

There are two main types of living kidney donation: directed and non-directed.

Directed Donation

Directed donation occurs when a donor and recipient know each other. The donor and recipient may or may not be related. In the past, for best results, donors and recipients needed to have matching blood types and the recipient’s body needed to be unsensitized. If a recipient is not sensitized, it means that the recipient’s antibodies should not attack blood and tissue from the donor, leading to organ rejection.

However, donors and recipients do not have to be an exact match. The Johns Hopkins Comprehensive Transplant Center developed a method, called plasmapheresis, that allows for a “non-matching” donor to still provide a kidney to a recipient. Through our Incompatible Kidney Transplantation Program (InKTP) and our Highly Sensitized Patient Protocol, more options are available for non-matching, directed donors and recipients.

Another directed donation option is to participate in a kidney swap, or exchange. Through this type of donation, a donor and recipient may trade kidneys with another donor/recipient pair. For example, if there were two donor/recipient sets, A and B, Donor A’s kidney would go to Recipient B, while Donor B’s kidney would go to Recipient A. When multiple donor/recipient pairs are used, this type of matching is called a Paired Kidney Exchange.

Non-Directed Donation

Non-directed donors, or altruistic donors, are individuals who choose to donate a kidney to an unknown recipient. This kind of donation has the potential to start a domino effect of kidney donations.

Can I Be a Living Donor?

Thank you for your interest in living kidney donation. The general requirements for living kidney donation are listed below. If you have any questions or are interested in living donation, please call 410-614-9345.

Criteria for live donation of a kidney:

  • Must be in good physical and mental health
  • Must be at least 18 years old
  • Must have a body mass index (BMI) that is less than 35
  • Must be free from the following:
    • Uncontrolled high blood pressure in certain individuals
    • Diabetes
    • Cancer
    • HIV/AIDS
    • Hepatitis
    • Organ diseases
    • Infectious diseases

Living donors also need a strong support system to rely on for emotional and physical needs during recovery.

Finally, the donation of any organ by a living person must be completely voluntary. Donors should be free from any pressure or guilt associated with the donation and cannot be paid for their donation. In 1984, the U.S. Congress passed the National Organ Transplant Act, which made it illegal to buy or sell organs.

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