The fears you have not said out loud. Answered honestly.

The honest number is now fewer than 1 in 10,000 - the risk is at an all-time low. A NYU Langone-led analysis of 164,593 U.S. donors across three decades found that by 2022, fewer than 1 death occurred per 10,000 donations, with 36 deaths in total over 30 years. Donor surgery is one of the most carefully screened operations in medicine, almost always done laparoscopically, and centers only proceed with people who are healthy enough that the risk stays this low. Long-term, donors live as long as or longer than matched healthy non-donors.

Expect incision soreness and - the part that surprises most donors - real fatigue for the first few weeks. It is managed with medication and it lifts steadily. Most people are back to desk work in two to four weeks and to full activity, including lifting and exercise, by six to eight weeks. It is genuine recovery, and it is temporary.

Yes, at any point, and confidentially. Every center assigns you an Independent Living Donor Advocate whose job is to protect you and your right to stop. If you withdraw, the center does not have to tell the recipient your medical reason - they can simply say you were not a match. The process is built so that no is always an option.

Yes. Your remaining kidney grows and compensates to roughly 60 to 70 percent of your prior two-kidney function, which is well within the range a body needs. Donors are counseled on a small absolute increase in the long-term chance of kidney problems - but because you were screened to be healthier than average, your risk stays lower than the general population's.

The data does not support that fear. There is a small absolute increase in the lifetime risk of end-stage kidney disease after donating, but it remains below the risk faced by the general public, and donor lifespan matches or exceeds that of comparable non-donors. Centers individualize this - and for donors of African ancestry, APOL1 genetic testing is offered so the conversation is specific to you.

Generally yes, with planning. Pregnancy after donation carries a modestly higher chance of gestational hypertension and preeclampsia - about 11 percent versus 5 percent in comparable non-donors - but most donors carry to term without complications. The guidance is simply to plan pregnancies with your nephrologist and obstetrician.

The average effect is small - on the order of a few mmHg above your expected trajectory over the long term. It is real but modest, and it is one of the things your annual follow-up checkup is designed to watch. Donors with a history of well-controlled blood pressure are not categorically excluded.

Regret is uncommon - roughly 5 to 10 percent of donors - and it clusters around specific, often preventable experiences: a recovery that was harder than expected, complications, or the recipient's transplant failing. Donors who go in well-prepared and well-supported report the best outcomes, and the large majority say they would donate again. Preparation is the strongest protection against regret, which is exactly what reading this is.

A transplant can fail, and that fear is reasonable. But living-donor kidneys last longest of any kind, and even a graft that eventually fails buys the recipient years of life off dialysis and a window for another option. You cannot control the outcome, only the gift - and the gift is real the moment it is given. This is a heavy one to sit with alone, and talking to someone who has been there helps.

It roughly doubles their life expectancy compared with staying on dialysis, and it takes them off three-times-a-week, hours-long dialysis sessions for years to come. It also moves everyone behind them on the waiting list up a place. Of every fear on this page, this is the one whose answer most people underestimate.

Your surgical and hospital costs as the donor are covered by the recipient's insurance, not yours. The real out-of-pocket worry is lost wages and travel, and there are programs built for exactly that: NLDAC reimburses up to about $6,000, and if your case is routed through the National Kidney Registry, Donor Shield adds up to $24,000 in lost-wage protection. Federal regulation also bars insurers from discriminating against you for donating.

Most donors need two to four weeks before returning to desk work. Federal FMLA protections, a growing number of state living-donor leave laws, and many employers' own donor-leave policies exist to cover that window. The Cost Navigator stacks the protections you specifically qualify for so you can see the real picture before you commit.

You will need someone to drive you home and to help for the first week or two - that is normal and expected, not a failure. Centers actually require you to have a support plan before surgery, precisely because they know recovery takes a village for a short while. It is a couple of weeks of help in exchange for someone's years of life.