Living kidney donation and possible surgery problems

What are possible problems from a kidney donation surgery?

Living kidney donation has a very low chance of causing problems. This is probably because donors are evaluated so carefully and are only allowed to donate if they have a low chance of problems from surgery.

But living kidney donation is still surgery and uses general anesthesia. Surgery problems can include:

  • Pain
  • Infection
  • Blood loss (which may require blood transfusions)
  • Blood clots
  • Allergic reactions to anesthesia
  • Pneumonia
  • Injury to other tissue or organs
  • And even death

Laparoscopy causes fewer surgery problems

Laparoscopy is a type of surgery where the surgeon makes 3 or 4 small cuts in your stomach area instead of 1 long cut (which is called open surgery).

Living kidney donors who have laparoscopy will have some pain at first, but compared to donors who have open surgery, they will have:

  • Less pain and discomfort
  • Less time in the hospital
  • An improved scar
  • Overall faster recovery after surgery

What are the surgery problem rates?

Several studies have found these rates:

  • About 3 out of 100 kidney donors (3%) had surgery problems
  • About 2 out of 100 (1.7%) had to go back into the hospital
  • 3-4 out of 1,000 donors (0.3%-0.4%) needed another surgery or a blood transfusion
  • About 3 in 10,000 donors (.03%) died – this is a small chance

Kidney donors who have laparoscopy have a lower rate of going back into the hospital 1 year after surgery when compared with patients who had similar surgeries, like appendix or gallbladder removal.

Living kidney donation has low rates of problems and re-admissions to the hospital. The medical evaluation is thorough to make sure that people who donate a kidney have a low chance of problems.

*Note: There is no difference in kidney patient outcomes if the donor surgery is laparoscopic or open. 


1. Nicholson ML, Kaushik M, Lewis GR, et al. Randomized clinical trial of laparoscopic versus open donor nephrectomy. The British journal of surgery. Jan 2010;97(1):21-28.

2. Davis CL. Living kidney donors: current state of affairs. Advances in chronic kidney disease. Jul 2009;16(4):242-249.

3. Rajab A, Pelletier RP. The safety of hand-assisted laparoscopic living donor nephrectomy: the Ohio State University experience with 1500 cases. Clinical transplantation. Mar 2015;29(3):204-210.

4. Nakajima I, Iwadoh K, Koyama I, Tojimbara T, Teraoka S, Fuchinoue S. Nine-yr experience of 700 hand-assisted laparoscopic donor nephrectomies in Japan. Clinical transplantation. Sep-Oct 2012;26(5):797-807.

5. Autorino R, Brandao LF, Sankari B, et al. Laparoendoscopic single-site (LESS) vs laparoscopic living-donor nephrectomy: a systematic review and meta-analysis. BJU international. Feb 2015;115(2):206-215.

6. Schold JD, Goldfarb DA, Buccini LD, et al. Hospitalizations following living donor nephrectomy in the United States. Clinical journal of the American Society of Nephrology : CJASN. Feb 2014;9(2):355-365.

7. Lentine KL, Lam NN, Axelrod D et al. Perioperative Complications  After Living Kidney Donation: A National Study. Am J Transplant. 2016 Jun: 16(6): 1848-57. 

Note: This information is the opinion of the Living Donor Community of Practice (LDCOP) of the American Society of Transplantation. The LDCOP is a group of health care professionals and researchers who specialize in living kidney donation. The LDCOP’s recommendations are meant to offer you helpful information, but you may find opinions from other groups or organizations that are helpful to you, too.

Last Updated: 
January 23, 2018