Press Release: Are you willing to share your spare?
August is Organ Donor Awareness Month, and TELL (Transplant Education for Living Legacies) is dedicated to raising awareness about the critical importance of organ donation. This month, we aim to educate the public about the life-saving potential of living donations.
There are 2 types of donors, a living donor and a deceased donor. A living donor can only donate a kidney or part of a liver and has to be in excellent health, whereas the deceased donor’s suitability will be assessed at the time of death to determine which organs and tissue can be donated.
Living organ donation
You can donate a kidney or part of the liver to a patient on the waiting list, this may be someone you know or a stranger. Donating to a stranger is called an altruistic donation. Donating to someone you know either a family member or friend is known as a related (RLD) or non-related donation (NRLD). A living donor needs to be in excellent health to withstand the operation and also to lead a normal life after donation. To be listed for a transplant, the recipient goes through a variety of tests and is assessed on an ongoing basis by their specialist. Only once the recipient has been cleared to be listed for a transplant, will the assessment of the living donor start. The work-up process for the donor is done in phases and can be stopped at any time if the donor changes his or her mind or if it comes to light that the donor has a medical condition that will prevent a transplant.
The World Health Organisation (WHO) defines donor selection: “Live donations are acceptable when the donor’s informed and voluntary consent is obtained, when professional care of donor is ensured and follow-up is well organised, and when selection criteria for donors are scrupulously applied and monitored.”
Source: WHO guiding principles on human cell, tissue and organ transplantation. Transplantation. 2010;90:229,
http://dx.doi.org/10.1097/TP.0b013e3181ec29f0
Financial incentives for living donation are prohibited by the Declaration of Istanbul, which South Africa is a signatory, and also by law in South Africa.
Table 1: Benefits of living donation for recipient and donor
Benefits for recipient: | Benefits for living donor |
Increase in the overall supply of kidneys and/or liver- opening up space on the transplant waiting list. | Provides an opportunity to save a life. |
Shortens time on the transplant waiting list for other patients in need. | Contributes to the recipient’s life as well as their family and friends in a meaningful and lifelong way. |
Surgery is usually performed before the patient’s condition worsens further, improving the odds of graft (kidney or liver) survival. | Living donors usually live longer due to being healthy to start with and also getting annual health checks. |
Surgery is scheduled at a time that is convenient for both parties. | Short hospital stay +/- 1 week |
The donated kidney starts to produce urine immediately. | The living donor can return to work 6 weeks after the operation. |
The liver grows to full size in 6-8 weeks | Can live a healthy/normal life with one kidney. |
Life-saving operation for liver recipients and improving the quality of life for kidney recipients. | Liver regenerates after 6-8 weeks |
Cost-effective treatment for kidney patients. | Right to withdraw for participation as a donor at any time. |
Only available treatment for liver failure. | The welfare of the living donor is paramount, transplant will not proceed if the risk to the donor is unacceptable. |
For kids, it improves cognitive and physical development. | Thorough medical evaluation at no cost to donor, cost are covered by recipients medical aid or by state. |
Can return to work full time or start a career, able to attend school/higher education full time. | |
More energy and time to spend with friends and family. |
Testing Process for Kidney and Liver Patients Awaiting a Transplant for patients awaiting a kidney/liver transplant, the testing process involves several crucial steps:
- Evaluation: Comprehensive medical evaluation, including physical examinations, medical history review, and psychosocial assessment.
- Blood Tests: Blood type and tissue typing to ensure compatibility with potential donors.
- Imaging Tests: Chest X-Rays and ultrasounds, to assess the current state of overall health.
- Functional Tests (liver recipient): Liver function tests, including bilirubin, albumin, and clotting factor levels, are crucial.
- Infection Screening: Testing for infections such as HIV, hepatitis, and other transmissible diseases.
- Cardiovascular Assessment: Ensuring the heart and blood vessels are in good condition to handle surgery.
- General: Pap smear, Mammogram, BMI, dental health.
*some of these tests will be repeated annually or as requested by transplant coordinator.
Tests for Living Donors for Kidney/Liver Transplants Living kidney/liver donors undergo a rigorous screening process to ensure they are healthy and suitable for donation:
- Initial Evaluation: Detailed medical history, physical examination, and psychosocial assessment to determine overall health and motivation.
- Blood Tests: Blood type and cross-matching to confirm compatibility with the recipient. Kidney donor: tests for kidney function (creatinine, eGFR). Liver donor: tests for liver function (ALT, AST, bilirubin).
- Imaging Studies: CT scans to assess the anatomical structure and function of the donor’s kidneys/liver. A liver biopsy might be performed.
- Cardiac Evaluation: Stress tests, echocardiograms, and other cardiovascular assessments to ensure the donor’s heart can withstand surgery.
- Infection Screening: Testing for infectious diseases like HIV, hepatitis B and C, and other transmissible infections.
- Psychological Assessment: Evaluating the donor’s mental and emotional well-being to ensure they understand the risks and benefits of donation.
Once all the tests are completed, the case will be presented to the transplant panel and once they approve the case will be referred to the Department of Health advisory committee for approval for a non-related living donation or altruistic donation. Only directly blood-related donors are not required to get approval from the Department of Health.
Who Can Be a Donor Living donors can be family members, friends, or even altruistic donors who volunteer to donate to someone they do not know. Key criteria include:
- Age: Typically 18 or older.
- Good Health: Donors must have good overall health without significant medical conditions that could complicate surgery or recovery.
- Compatibility: Blood type and tissue matching with the recipient.
- Informed Consent: Donors must fully understand the risks and benefits and voluntarily consent to the procedure.
The Nel family found themselves in a unique situation, as both parents were able to donate a kidney to their daughters, who suffer from a rare disease that causes kidney failure and will eventually lead to liver failure. Read more about their story Orgust Living donation
During Organ Donor Awareness Month, TELL encourages individuals to learn more about living donation and consider becoming a donor. By stepping forward, you can give someone a second chance at life.