Who Benefits From Living Donation?
First of all, the patient receives a lot of benefits from living donation. They can receive an organ of a healthy person without cytokine release syndrome, without prior damage and without underlying or additional disease.
Not only patients benefit from living donation, the operation can be planned in advance, so everyone involved can plan ahead and look for the most beneficial time for the transplantation. While postmortem transplantation is always a sudden emergency situation, often performed during the late hours and involving much stress for all participants, a living donor kidney is planned and thus the kidney can be retrieved and transplanted during daytime, after a period of relaxation.
It is no surprise that every surgeon and transplant physician prefers transplantation during daytime, nor is it surprising that such an organ is more likely to grant a longer graft and patient survival than an organ retrieved from a postmortem donor.
There is a large benefit for society in general as well. A patient is off dialysis faster and for a longer period of time than would be possible with postmortem donation, adding ~6–7 years of financial gain to transplantation. With costs ranging in European countries from 20 000 to 60 000€ for 1 year of dialysis, a living donation is likely to save an average of 280 000€.
At times in which there is a shortage of organs, living transplantation is a vital way of increasing the number of organs available for the benefit of our patients. We must also mention that the higher the number of transplantations, the better the reputation for the transplant centre. Furthermore, in some centres, the number of transplantations is so high that it is responsible for a substantial part of the hospital budget. This income can be used for the benefit of the centre, the surgeons and/or the transplant physicians. In other words, if a centre performs fewer transplantations, it may be inclined to reduce the number of physicians or other personnel involved in the field of transplantation.
Ultimately, the society saves a substantial amount of money, the transplant centre and the physicians earn a better reputation and the recipients gain precious lifetime. However, what is the gain for the donor? The only real benefit for them is most probably emotional well-being. Under these conditions, a lot of emphasis has to put on the safety of the living donor.
Nephrol Dial Transplant. 2012;27(6):2166-2170. © 2012 Oxford University Press