Roshan, 35, came to my clinic that afternoon, feeling anxious and impatient. His closest brother was suffering from end-stage renal failure, and Roshan was ready to save his brother's life by donating one of his kidneys.
"Dr. Priya, I have decided to donate one of my kidneys to my brother. But can I stay healthy for the rest of my life with one kidney? Will I develop kidney disease later? How does the legal process of kidney donation work in Sri Lanka?" Roshan asked me with hopeful eyes.
I patted Roshan on the back and appreciated his noble and selfless decision and explained: "Roshan, this organ donation you are about to do for your brother is truly a noble act. And don't worry, a person can live a completely healthy, normal life with just one kidney. Kidney transplants are performed under strict medical regulations and ethical checks in Sri Lanka. Today, we will simply talk about this entire process and the things you need to be careful about."
๐จ Red Flags When to Seek Immediate Medical Care After Kidney Surgery
A donor or recipient who has donated a kidney should seek immediate medical attention if they experience any of the following complications after surgery:
- Severe pain or fever in the kidney area.
- A sudden decrease in urine output to a very low level.
- Blood in the urine or a burning sensation when urinating.
- Sudden swelling of the hands, feet, or face (fluid retention) and difficulty breathing.
Legal background of kidney transplantation in Sri Lanka
The first successful kidney transplant in Sri Lanka was performed in 1985. Since then, more than 1,500 surgeries have been successfully performed.
All organ transplants in Sri Lanka are carried out under the Organ Donation Act No. 48 of 1987. This Act completely prohibits organ trafficking and ensures that organ donation is completely voluntary and altruistic. It is mandatory to obtain Ethical Committee Approval before every operation.
Who can donate a kidney?
Kidney donors can be divided into several main categories:
1. Related Donors: Mother, father, siblings or children. Their tissue matching ability is very high.
2. Unrelated Donors: Friends or acquaintances who volunteer on behalf of the patient.
3. Paired Exchange:If Roshan's kidney is not a match for his brother, the method is to exchange donors with another similar incompatible pair to provide a compatible kidney for both.
4. Deceased/Cadaveric Donor: Organ donation from a brain-dead person based on the wishes of the family or as registered while the person was alive.
Kidney donation process step by step
A person wishing to donate a kidney must undergo the following series of rigorous medical tests:
1. Medical Evaluation:
Blood density matching, cross-matching , and kidney function tests are performed. It is important to ensure that the donor does not have diabetes, high blood pressure, or heart disease.
2. Psychological Counseling:
A psychiatric consultation is conducted to determine whether the donor is willing to do this voluntarily, is mentally strong, and whether anyone is exerting financial influence.
3. Age restrictions and consent:
To donate a kidney in Sri Lanka, a male must be over 25 years of age and a female must be over 30 years of age. Written consent from the donor and family is also required.
4. Surgery:
Currently, the most common method of minimally invasive surgery is Laparoscopy . This results in minimal pain for the donor, minimal scarring, and allows the donor to return to normal life within a few weeks.
Risks of living with one kidney
After surgery, the remaining kidney naturally increases its function by about 30%, performing all the work needed by the body on its own.
However, in the long term, the following risks may be very small:
- Proteinuria: Protein leakage from the urine may occur as the kidneys have to work harder.
- High blood pressure: Blood pressure may rise slightly due to changes in the kidney's filtration rate.
- Preeclampsia: A woman who has donated a kidney may have a slightly increased risk of developing high blood pressure during pregnancy.
Therefore, it is very important to have blood pressure, serum creatinine, and urine tests at least once a year after donating a kidney.
Do's & Don'ts
| โ๏ธ Things to do (Do) | โ Don'ts |
|---|---|
| To register to donate a kidney, visit the government's organ donation foundation.Visit the ODTF Sri Lanka website. | Never accept money for organ donation or deal with illegal intermediaries. |
| As someone with one kidney, drink enough water daily and limit salt intake. | After donating a kidney, do not skip the annual medical checkups recommended by doctors. |
| Avoid prolonged use of painkillers (NSAIDs) without medical advice as they can cause kidney damage. | Do not drink alcohol excessively or eat foods high in unhealthy fats. |
โ Some other questions you may have (FAQ)
Will the donor's lifespan be shortened after donating one kidney? โผ
No, research has shown that the lifespan of kidney donors is no different from that of the general population. They can live a normal life if they follow a healthy lifestyle.
How long does it take to fully recover after kidney donation surgery? โผ
After minimally invasive (laparoscopic) surgery, you can go home from the hospital in 3-5 days, and you can return to normal activities and employment within 4-6 weeks.
Can a woman who donates a kidney get pregnant later? โผ
Yes, there is no problem with getting pregnant normally. However, it is safer to inform your obstetrician and gynecologist and nephrologist before getting pregnant that you have one kidney and be under special medical supervision.
What health conditions make it impossible for people to donate a kidney? โผ
People with diabetes, serious heart disease, cancer, incurable infections, long-term kidney disease, or uncontrolled high blood pressure are not allowed to become organ donors.
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