The whole road, before you take the first step.

You contact a transplant center, or the recipient's center contacts you, and you give some basic health information by phone or a short online form. Nothing is decided. You are not signing up for surgery by making a call.

Every OPTN-accredited center assigns you an Independent Living Donor Advocate (ILDA) - a person whose entire job is to represent you, separate from the recipient's care team. You can ask to speak with them privately at any point.

Your part

• Make the first contact, or accept the center's call.
• Answer basic health questions honestly.
• Know that you can stop here, or at any later point, without having to explain why.

This is the longest stage and the most thorough. The center checks that donating is safe for you: blood and urine tests for kidney function, imaging of your kidneys (a CT or MR scan), infectious-disease and cancer screening, blood typing, and a cardiovascular check. Much of it is one visit or a single round of labs.

You also meet a transplant social worker or psychologist for a psychosocial assessment, and you meet your ILDA. This is not a test you can fail by being nervous; it is there to confirm the decision is freely yours and that you will have support during recovery.

Your part

• Show up for labs, imaging, and appointments.
• Line up the modifiable pieces ahead of time if you can - weight, blood pressure, tobacco-free status. Renara coaches exactly these.
• Ask your coordinator anything. There are no questions that are too small.

Once you are cleared, you go through informed consent: the surgeon walks you through the operation, the anesthesia, the recovery, and the long-term outlook. You can ask to speak with a former donor through the free NKF Peer Mentor program - someone who has been exactly where you are.

This is the point to talk it through with the people in your life and to sit with the decision. A clear-eyed yes here is strongly associated with a good experience afterward.

Your part

• Have the surgeon conversation and ask your real questions.
• Consider a peer-mentor call - donors who do this report feeling far more prepared.
• Confirm who will help you at home for the first week or two.

Donor nephrectomy is almost always done laparoscopically - a few small incisions and one slightly larger one to remove the kidney - under general anesthesia. You are asleep for the whole thing and feel nothing during the operation. It typically takes two to three hours.

You wake up in recovery. Most donors stay in the hospital one to three nights. You will have some incision pain and grogginess, which the team manages with medication.

Your part

• Follow the pre-surgery fasting and medication instructions.
• Arrange your ride home and your first-week support in advance.

The early weeks are about rest and healing. Expect fatigue, mild incision soreness, and lower exercise tolerance at first. Most donors return to non-strenuous (desk) work in two to four weeks. Heavy lifting and intense exercise wait until six to eight weeks so the incision can fully heal.

You will have follow-up checks with the center during this window. Day by day, the fatigue lifts and your energy returns.

Your part

• Rest, walk a little more each day, and do not rush the lifting restriction.
• Lean on the support you lined up. Needing help for a week or two is expected, not a burden.

After full recovery, donors return to normal life without dietary restrictions and with no limits on running, swimming, or weight training. Your remaining kidney compensates to roughly 60 to 70 percent of your prior two-kidney function, which is plenty.

OPTN requires the center to follow up with you at 6 months, 1 year, and 2 years. After that, donors are encouraged to keep an annual primary-care visit with simple kidney labs. Pregnancy after donation is generally safe with planning. Living donors are protected from insurance discrimination by federal regulation.

Your part

• Keep your follow-up appointments and an annual checkup.
• Stay in normal healthy habits - hydration, moderate sodium, activity.