Transplant Guide
Living Donor Transplants: What Patients and Donors Need to Know
Living donation offers shorter wait times and better outcomes, here is how the process works, what the data shows, and what donors can expect.
This guide in one line
Kidney, the organ with the most established living-donor program, also posts the highest national 1-yr survival of any organ tracked (95%, across 207 programs). Liver, the other living-donor-eligible organ, follows at 92.4% -- both ahead of the fully deceased-donor-only organs on this list.
- Kidney national 1-yr survival
- 95%
- Liver national 1-yr survival
- 92.4%
- Kidney reporting programs
- 207
Why Living Donation Matters
Living donor transplants bypass the deceased-donor waiting list entirely. For kidney transplants, where wait times can exceed 5 years, a living donor can mean the difference between years on dialysis and a transplant within months. Living donor kidneys also last longer on average: median graft life of 15-20 years compared to 10-15 years for deceased donor kidneys.
The reason is straightforward: a living donor kidney is transplanted immediately after removal, minimizing the time the organ spends without blood flow (cold ischemia time). Deceased donor organs may travel for hours before transplant, and the donor's medical events before death can affect organ quality.
Types of Living Donation
Kidney: The most common living donor transplant. Donors can live healthy lives with one kidney, the remaining kidney compensates by increasing its filtration capacity. About 6,000 living donor kidney transplants are performed annually in the US.
Liver: Living donor liver transplants involve removing a portion of the donor's liver. Both the donor's remaining liver and the transplanted portion regenerate to near-normal size within weeks. This is more complex surgery with higher donor risk than kidney donation.
Paired exchange: When a willing donor is incompatible with their intended recipient, paired kidney exchange programs match incompatible pairs with each other. Donor A gives to Recipient B, and Donor B gives to Recipient A. National chains can involve dozens of pairs.
The Donor Evaluation Process
Potential living donors undergo extensive medical and psychological evaluation. The transplant center must determine that: the donor is medically suitable (healthy kidneys/liver, no conditions that increase surgical risk), the donation is voluntary and free of coercion, and the donor understands the risks and alternatives. This evaluation typically takes 1-3 months and includes blood tests, imaging, cardiovascular assessment, and meetings with an independent donor advocate.
Not all willing donors qualify. Common disqualifiers include uncontrolled hypertension, diabetes, obesity beyond certain thresholds, kidney stones, and certain infectious diseases. Each center sets its own criteria, so being declined at one center does not necessarily mean another will decline you.
Outcomes: What the Data Shows
Living donor kidney transplants have consistently better outcomes than deceased donor transplants across all metrics. One-year graft survival exceeds 97% nationally (compared to ~95% for deceased donor). Five-year graft survival is approximately 90% versus 82%. These differences persist after risk adjustment.
For donors, long-term studies (including a major 2014 JAMA study following 96,000 living kidney donors) show that donors have normal life expectancy compared to the general population. The risk of developing kidney failure as a donor is slightly elevated (about 90 per 10,000 over 15 years, compared to 30 per 10,000 in the general population) but remains low in absolute terms.
Kidney and liver are the two organs on this list where living donation is a real option in the US. Their strong national position isn't proof living donation alone drives it (case mix, transplant volume, and surgical maturity all matter too), but it's consistent with living donation's shorter cold-ischemia-time advantage described above.
What This Means for You
If you are a patient: Ask your transplant center about living donation early, even before you reach the top of the deceased donor waiting list. If family or friends offer to be evaluated, encourage them. If no compatible donor is available, ask about paired exchange programs. Browse our center directory to find programs with active living donor programs.
If you are a potential donor: Start with a phone call to the transplant center where the recipient is listed. The initial screening (blood type check, basic health questions) can often be done by phone. The full evaluation is thorough but the medical team is there to ensure your safety, not to create barriers.
Financial information outside this registry
PlainTransplant’s SRTR extract contains no fields for donor expenses, insurance coverage, reimbursement, financial assistance, or eligibility. It therefore cannot show what an evaluation, donation, travel, leave from work, or insurance arrangement would cost for any person.
The National Living Donor Assistance Center’s current eligibility information is the primary source for its reimbursement program. Its published criteria, covered expenses, and eligibility rules are administered outside this registry and may change.
Frequently Asked Questions
What is a living donor transplant?
A transplant using an organ from a living person, usually kidney or partial liver. Living donor kidneys have better outcomes and longer graft life because of less cold ischemia time.
How long is recovery for a living kidney donor?
Hospitalization: 2-3 days. Full recovery: 4-6 weeks. Many donors return to sedentary work within 2-3 weeks. Long-term kidney function is normal.
Can a family member donate a kidney?
Yes. Family, friends, spouses, and altruistic strangers can all donate. Paired exchange programs also allow incompatible pairs to swap.
Reading this guide
- Living donation bypasses the deceased-donor wait entirely -- ask your transplant center about it early, even before you reach the top of the list.
- Kidney posts the highest national 1-yr survival of any organ tracked (95%) -- consistent with, though not proof of, living donation's advantage. Kidney transplant guide
- Paired kidney exchange can still work even if your donor is incompatible with you specifically. Find a program
Survival statistics are population medians from past cohorts, not predictions for any individual; consult your transplant team.
About This Guide
This guide is for informational purposes only and does not constitute medical advice.
Sources: SRTR (November 2025), OPTN, UNOS, National Kidney Foundation, and the National Living Donor Assistance Center for its reimbursement-program information.
PlainTransplant’s data pages are rendered directly from SRTR Program-Specific Reports, no number on them is typed in by an editor. This page is written explanation rather than a data page, and any illustrative figures in it are labelled as illustrative. Written explanation of how the SRTR measures work; the center-level numbers behind it live on the data pages this guide links to. See our editorial standards & corrections policy, the methodology behind these numbers, or report a correction.
How to use PlainTransplant data for your decision
Start with the waiting list guide to understand the allocation system, then use the transplant center directory to compare programs in your region against national benchmarks. For survival-rate interpretation, read what survival rates mean - raw numbers without risk-adjustment context can be misleading. Finally, the center-selection guide walks through how volume, waitlist size, and acceptance criteria interact. The center-level metrics we publish are rendered from SRTR Program-Specific Reports (November 2025); this guide is our written explanation of what those measures mean. Use the numbers as inputs to a conversation with your transplant team, not as a substitute for it.