Living Kidney Donor Conversations: Breaking the Silence – Stage 6 – Surgery

Stage 6 Living Kidney Donor

There are 8 Living Kidney Donor Stages:

As you progress through the living kidney donation process, the testing is completed, the transplant team has met and approved you to donate, and now the surgery date will be discussed. You are moving into Stage 6.

Stage 6 Surgery

This surgery stage requires planning before a date is set.

After you have been approved to donate, it may be 4 weeks or more until surgery. The surgery date will need to work for you, your surgeon, your recipient, their surgeon, and the operating room teams.  Your donor coordinator will be helping to set this date, so talk to them if you have any questions or concerns. Let them know about any future dates that are not good for you, such as work, family, or any other personal business, so those dates will not be considered.

Even after a date is set, if the person getting your kidney unexpectedly gets sick, surgery could be delayed until they are healthier.

Pre-Op Visit

About a week before surgery, you will have a pre-operative visit. This is when you will have more testing of blood, urine, COVID-19, etc. that is needed before the day of surgery. You will meet with the surgeon, anesthesia doctor, and your donor coordinator nurse to discuss further details of the surgery. You will be provided information about when and where to come to the hospital before surgery, how the team will talk with your family, and what happens after surgery. They may have you sign the surgical consent form at this time.

You typically can bring one person with you to this visit. This is a time to ask more questions about the surgery, the hospital stay, and the post-op recovery plan.

Some donors may have a bowel prep the night before surgery. This will depend on the surgeon and hospital protocol. The bowel prep might help to lessen the discomfort from the gas after surgery. Ask your surgeon or nurse if they will be ordering a bowel prep and if so, the specific directions for taking it.

You will also be told what to eat and drink the day before surgery and what time to stop eating and drinking. Writing down this information and placing it in a calendar will help you to remember when the time comes.

Due to COVID-19, you may have special instructions for getting a COVID test on the day of surgery. They will need those results for you and your recipient before going to the operating room.

Independent Living Donor Advocate

You will also talk with your Independent Living Donor Advocate at the pre-op visit. This is a person assigned to you, to help make sure your rights are protected, respected, and maintained throughout the donor process. You should have first met your advocate sometime during the full workup process. If you have any concerns about donating, it is important to talk with them before going to surgery. 

Surgery Day

You will go into surgery before your recipient so the team can begin the process of removing your kidney. Later, your recipient will go into surgery and will be prepared to receive your kidney.

Often, both of you will be in the same hospital and in operating rooms next to each other. Your kidney is removed and immediately taken to the recipient.

Sometimes, the donor and the recipient will be in different hospitals and may even be in different states. In this case, the kidney is removed, carefully packaged, taken to an airplane, and flown to where the recipient is. It is then taken to the recipient hospital, into surgery, and placed.

Normally, the kidney from a living donor starts working right away, making urine for the recipient and immediately cleaning their blood of waste and toxins. 

Surgery often lasts around 4 hours. The team will be talking with your family during this time to keep them updated on the process.

Immediately after Surgery

After your procedure is done, you will go to the recovery room. As you are waking up, you will notice an oxygen tube in your nose, IVs in your arm, a catheter going into your bladder to collect your urine, pressure cuffs on your legs to help prevent blood clots, and a bandage covering the new incision areas where your kidney was removed. You may have several smaller incisions, depending on the exact surgical technique. 

Your nurse and doctor can answer questions you may have about how the surgery went, the status of your kidney, and the plan for recovery. 

Want to learn more?

Future posts of the “Living Kidney Donor Conversations: Breaking the Silence” series will provide you with general guidelines of what the journey looks like, even though every individual situation is unique. Get ready for more of this living kidney donor adventure! Stage 7 is next.

All the posts in the Living Kidney Donor Conversations: Breaking the Silence series can be found here:



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Glenna Frey, APRN-CNS, is a nephrology nurse who donated her kidney in April 2017 to a stranger.
Amanda Frey, M.A., LMFT, LPC, is a Marriage & Family Therapist living with kidney disease.
Together, they co-founded Kidney Donor Conversations in 2018 to provide education about Living Kidney Donation.

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