
Living donor nephrectomy
Living donor nephrectomy is the surgical removal of one healthy kidney from a living volunteer so it can be transplanted into someone whose own kidneys have failed. It's performed for the recipient's benefit, not to treat any illness of the donor's own.

Briefly about this treatment
Indications
A compatible, willing adult is available to donate a kidney to someone with end-stage kidney disease (ESRD) or severe, worsening chronic kidney disease, so the recipient can avoid or come off dialysis sooner than a deceased-donor kidney would allow.
Risks
Bleeding, infection, and rare injury to nearby organs or blood vessels during extraction. Risks are minimised through careful donor screening, experienced transplant teams, and a minimally invasive (laparoscopic) technique wherever appropriate.
Pre-procedure
A comprehensive donor work-up: blood and tissue typing, kidney imaging, cardiac assessment, a psychological evaluation, and fasting before surgery per the transplant center's protocol.
Follow-up
Scheduled clinic visits around two months after surgery, then annually, to monitor kidney function, blood pressure and overall donor health for the long term.
What is Living donor nephrectomy? An expert explains
A healthy adult has two kidneys but only needs one to live a full, normal life. In living donor nephrectomy, a transplant surgeon removes one of the donor’s kidneys β today, almost always using a laparoscopic (minimally invasive) technique, occasionally with robotic assistance: a few small incisions, a camera, and slim instruments, rather than one large open cut. The surgeon carefully frees the kidney, divides its blood vessels and ureter, and lifts it out through a small incision, often just below the bellybutton. It’s then flushed with a cold preservation solution and taken straight to the recipient’s operating room.
Living donation matters because it changes outcomes: a kidney from a living donor can often be transplanted before the recipient ever needs dialysis, and it tends to start working sooner and last longer than a kidney from a deceased donor.
Signs it may be time for Living donor nephrectomy
Thereβs no symptom of your own that signals itβs time for this surgery β living donor nephrectomy is prompted by someone elseβs kidney failure, not your own illness. Youβre a healthy volunteer by definition. But if youβre reading this page, itβs usually because someone close to you β or someone you donβt know, if youβre considering altruistic donation β is showing the signs that their kidneys are failing and a transplant is being discussed:
- Persistent fatigue and low energy that doesnβt improve with rest
- Swelling in the legs, ankles or around the eyes from fluid buildup
- Noticeably less urine than usual, or foamy urine
- Nausea, poor appetite, or a metallic taste that wonβt go away
- Difficulty concentrating or βbrain fogβ
- Persistent itching
These are signs of advancing kidney failure in the person who may need your kidney, not signs that you yourself need this procedure.
These are the conditions linked to this treatment in the directory. Your clinician decides whether transplant is appropriate using the intended recipientβs symptoms, examination and test results β not yours.
- Chronic Kidney Disease (CKD) β Progressive, long-term loss of kidney function.
- End-Stage Renal Disease (ESRD) β Final stage of kidney failure requiring dialysis or transplant.
- Polycystic Kidney Disease (PKD) β Inherited disorder with fluid-filled cysts in kidneys.
- Diabetic Nephropathy β Kidney damage caused by long-term diabetes, a leading cause of kidney failure.
- Glomerulonephritis β Inflammation of the kidneyβs filtering units that can progress to kidney failure.
Remember: These entries are not a diagnosis or a treatment recommendation. Discuss your symptoms and test results with a qualified clinician.

When to consult a specialist
If someone close to you is nearing dialysis or has been told they’ll eventually need a transplant, there’s no need to decide anything today. A simple blood test can usually confirm whether you’re a potential match, and most transplant centers will walk you through what to expect before you commit to anything further. Taking this first step doesn’t obligate you to donate β you can step back at any point. When you’re ready to talk it through with someone qualified, you can find a specialist to guide you through matching, evaluation and what donation would involve for you.
How a session works
- Anesthesia. You’re given general anesthesia, so you’re fully asleep and feel nothing during the operation.
- Access. The surgeon makes three to five small incisions in the abdomen for the laparoscope (camera) and instruments.
- Freeing the kidney. The surgeon carefully separates the kidney from surrounding tissue and identifies its artery, vein, and ureter.
- Disconnecting the kidney. The blood vessels and ureter are divided using surgical staplers or clips.
- Extraction. The kidney is lifted out through one slightly larger β but still small β incision, usually near the bellybutton or lower abdomen.
- Handover. The kidney is flushed with cold preservation fluid and taken immediately to the recipient’s operating room, where the transplant surgeon places it and reconnects it to the recipient’s blood supply.
- Closing. Your incisions are closed and you’re moved to recovery.
Benefits
Living donation changes outcomes for everyone involved, even though the surgery itself offers no physical upside to the donor.
- For the recipient: a living-donor kidney can often be transplanted before dialysis becomes necessary, shortens or removes the waiting period, and tends to start working sooner with better long-term function than a deceased-donor kidney.
- For the donor: the chance to give someone years of life free from dialysis β a benefit that’s emotional and relational rather than physical, since living with one healthy kidney carries no medical advantage of its own.
- For the healthcare system: more living donations mean shorter waiting lists for everyone else on the transplant list.
Risks & side effects
The treatment has risks and trade-offs to discuss with your care team. The information below comes from this treatmentβs clinical data.
Incision-site pain, shoulder-tip pain from surgical gas, fatigue, and temporary bloating are common and usually short-lived. Less common risks include bleeding, infection, a hernia at an incision site, injury to a nearby organ, blood clots, or a reaction to anesthesia. Risks are minimised by careful donor selection and experienced transplant teams.
Who it may not suit: people with uncontrolled high blood pressure, diabetes, significantly reduced kidney function, a history of kidney stones or certain cancers, or unresolved psychological concerns about donating may not be suitable candidates. These are general cautions, not a personal verdict. A qualified clinician must assess your full medical picture before recommending or delaying donation.
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What happens during & after
You’ll wake up in a recovery area with pain relief already on board, while nursing staff monitor your vital signs, urine output, and incisions. Laparoscopic surgery uses gas to create working space inside the abdomen, and trapped gas is one of the more uncomfortable β though temporary β parts of the first day or two; some donors notice shoulder-tip or abdominal gas pain in the first 24β48 hours. You’ll be encouraged to get up and walk the same day or the next, which supports recovery and lowers the risk of blood clots. Most donors stay in hospital for one to two nights before going home.
A small number of donations still use traditional open surgery, usually when anatomy or a prior operation makes the laparoscopic approach unsuitable. Open donor nephrectomy takes a similar two to three hours but involves a longer hospital stay β typically four to six days β and a fuller recovery of six to twelve weeks. Your surgical team will discuss which approach fits your situation well before the day of surgery.
Possible complications
Most donors never experience any of the following β this list exists so you know what to watch for, not because it’s expected. Contact your transplant team promptly if, after going home, you notice:
- Fever or chills
- Increasing redness, swelling, or drainage at an incision
- Pain not controlled by your prescribed medication
- Reduced urination
- Chest pain or shortness of breath
The largest long-term study of laparoscopic donor nephrectomy to date β over 3,000 donors followed at one transplant center across two decades β found no donor deaths, with major complications occurring in a small minority of cases (about 1 in 40) and any postsurgical complication, most commonly a wound infection or hernia, occurring in roughly 1 in 8 donors.
This information is educational and doesn’t replace a one-to-one risk conversation with your own transplant surgeon, who can weigh your personal health history.
New or severe symptoms require prompt medical advice. Do not wait for a routine appointment if you feel seriously unwell.
Recovery
In hospital (day of surgery β day 1β2): pain management, monitoring of urine output and kidney function, early walking, and a gradual return to normal eating. Most donors are discharged within one to two nights.
At home β the first 4β6 weeks:
- Follow-up appointments with the transplant team to check on your health and healing.
- Driving: most centers suggest waiting around 4β6 weeks, resuming once you feel ready and are off strong pain medication.
- Exercise: start gently and build back up gradually β staying active supports long-term health with one kidney.
- Work: many donors return to desk-based work within two to four weeks; physically demanding jobs may need longer, discussed individually with your surgeon.
- Intimacy: no direct medical risk; resume when you feel physically comfortable, which may take a few months for some donors.
Emotional recovery: It’s normal to feel a mix of pride, anxiety, or even doubt during recovery β donating an organ is a significant act, physically and emotionally, and psychological support can be arranged if you feel overwhelmed. Most donors describe the experience as meaningful once recovery is behind them, but accounts vary β some report more discomfort in the first couple of days than expected, particularly from surgical gas, so it’s worth planning for extra rest and support at home.
Long-term follow-up: Transplant centers typically schedule check-ups at set intervals β around two months after surgery, then annually β to check blood tests, blood pressure, and urine as part of ongoing donor care, not because a problem is expected.
Specialists for Living donor nephrectomy
Specialists linked to this treatment in the KidneyGlobal directory. Review credentials and confirm availability directly before booking.
Verified specialists



Clinics offering Living donor nephrectomy
Verified kidney centres linked to this treatment in the KidneyGlobal directory.


Northwestern Memorial Hospital Transplant Institute
β Accredited
Cleveland Clinic Glickman Urological & Kidney Institute
β Accredited
Mayo Clinic Kidney & Pancreas Transplant Center
β AccreditedMost Common Questions
Can I live a normal life with one kidney?
Yes. Living kidney donors do not have a shorter life expectancy because of donating, and most return to their usual work, hobbies, and activity levels once recovery is complete.
Will I need to change my diet after donating?
Most donors don't need a special diet long-term, though your team may give you general kidney-friendly guidance as a precaution.
Can I donate to a stranger?
Yes β this is called non-directed or altruistic donation, and many transplant centers actively welcome it.
What if I'm not a match for the person I want to help?
You may still be able to help through a paired exchange program, donating to a compatible stranger so your loved one receives a matching kidney in return.
Is donation reversible if I change my mind?
You can step back at any point during the evaluation process, and the healthcare team will support that decision without judgment.
Is the surgeon who removes my kidney the same one who transplants it?
No β separate teams typically handle the donor and the recipient, though they coordinate closely and operate on the same day.
Sources
- Becoming a Living DonorNational Kidney Foundation (NKF)
- Mayo Clinic study confirms living kidney donor surgery is low risk for most patients (summarizing Benavides X, et al., Mayo Clinic Proceedings, 2022)Mayo Clinic News Network
- Risk of End-Stage Renal Disease Following Live Kidney Donation (Muzaale AD, Massie AB, Wang MC, et al., JAMA, 2014;311(6):579β586)JAMA
- Laparoscopic Donor Nephrectomy (procedure overview β incisions, timing, extraction technique)UCSF Transplant Surgery
- Living Kidney Donor patient page (follow-up schedule, driving, exercise, intimacy, emotional support)Sheffield Teaching Hospitals NHS Foundation Trust
- HCPCS 50320 β Kidney Removal From A Living Donor (nationwide rate data, July 2026)Insurer price-transparency data aggregator