What Does Kidney Donor Surgery Involve?

If you are donating a kidney, you will undergo kidney removal surgery (nephrectomy), which is a surgical procedure to remove a healthy kidney from a living donor for transplant into a person whose kidneys no longer function properly.

The surgery usually takes about two to three hours, but can take anywhere from one to five hours. You will be under general anesthesia and will be asleep for the entire procedure.

While nephrectomy is major surgery and no surgery is risk-free, it is actually one of the safest types of surgery. In a 20-year Mayo Clinic study of more than 3,000 living kidney donors, only 2.5% of patients in the study experienced major complications from kidney donation surgery and all recovered completely.

Most kidney removals are done using laparoscopic surgery, which is a minimally invasive surgery that uses small incisions and a special camera. Laparoscopic surgery typically results in a shorter hospital stay, less pain and scarring, faster recovery time, and fewer postoperative complications. 

For laparoscopic kidney donation surgery, the surgeon will make one or more small incisions in your abdomen. Some centers will make up to four incisions, others use a newer type of laparoscopic surgery called single-port donor nephrectomy, also known as laparoendoscopic single-site (LESS) surgery, which uses just one incision in the belly button. Once the incision(s) have been made, carbon dioxide is pumped into the abdominal cavity to inflate it, which improves visibility for the surgeon.

The laparoscopic camera and surgical instruments are inserted through the incision(s), and the kidney is freed from the surrounding tissue. The surgeon then places the kidney in a bag and pulls it out through one of the incisions. Once the kidney has been removed, the surgeon closes the incision(s).

In cases where laparoscopic surgery is not possible, you may have open surgery to remove your kidney. In open nephrectomy, the surgeon makes a 5- to 10-inch incision on the side of the chest and upper abdomen to access the donor’s kidney. In rare cases, there may be complications during the procedure that require the surgeon to covert a laparoscopic nephrectomy to an open procedure.

Your transplant center can give you the most current medical information about the specific surgery you will undergo.