Living donors can donate one kidney, a segment of the liver, one lobe of a lung, part of the pancreas, or part of the intestine. Kidney and liver donations make up the vast majority of living donor transplants, while lung, pancreas, and intestine donations are rare. Here’s what each donation involves, how your body adapts afterward, and what recovery looks like.
Kidney: The Most Common Living Donation
Donating a kidney is the most straightforward form of living organ donation because you have two and can live a full life with one. After surgery, the remaining kidney compensates by increasing its filtering capacity to about 70% of what both kidneys handled together. That compensation tends to be stronger in younger donors.
Long-term outcomes for kidney donors are reassuring. Studies comparing donors to matched controls over periods of 6 to 17 years have generally found no increased risk of heart disease or death. About 12 years after donation, roughly 86% of donors in one large study still had healthy kidney function, and most reported an excellent quality of life. The risk of eventually developing kidney failure is real but very small: in a U.S. study of more than 96,000 living donors, only 99 developed kidney failure.
A few health factors do shift the long-term picture. For each unit of BMI above 27 at the time of donation, the risk of later kidney failure rises by about 7%. And conditions that can develop years after surgery, like high blood pressure (which appeared in about 27% of donors over 16 years of follow-up) or type 2 diabetes (about 8% over 18 years), deserve ongoing monitoring.
Liver: The Organ That Regrows
The liver is the only internal organ that regenerates, which makes partial liver donation possible. Surgeons typically remove the right lobe, which accounts for 55% to 80% of the liver’s total volume. The donor needs to retain at least 30% to 35% of their original liver volume to avoid complications, and the remaining portion grows back over the following weeks and months.
Recovery from liver donation is more involved than kidney donation. Most donors spend five to seven days in the hospital and are out of work for four to six weeks. Full recovery, meaning feeling completely back to normal, often takes four to six months. You’ll also be asked to return for checkups at one year and then annually for five years.
Lung, Pancreas, and Intestine
These donations are possible but uncommon. A living donor can give one lobe of a lung, a portion of the pancreas, or a segment of the intestine. Unlike the liver, these organs don’t regenerate. The portion you donate and the portion that stays behind can each function on their own, but the surgery carries more complexity, and finding a suitable match for these procedures is less common. Lung lobe donations, for instance, sometimes require two living donors to provide enough tissue for a single recipient.
Who Can Be a Living Donor
Federal policy lists fourteen criteria that exclude someone from donating. The clearest disqualifiers include active or incompletely treated cancer, type 1 diabetes (for kidney donation), being a minor, and being unable to make an informed decision. People with a history of substance use disorders or certain psychiatric conditions also face additional screening. Any evidence of coercion or financial exchange between donor and recipient is grounds for exclusion.
Beyond those hard rules, transplant teams evaluate each potential donor individually. Your blood type, organ function, BMI, blood pressure, and overall health all factor into the decision. The evaluation process itself is extensive, often involving imaging, blood work, and psychological assessments spread over multiple appointments.
Recovery and Time Off Work
For kidney donors, hospital stays are typically two to three days, with most people returning to desk jobs within two to four weeks. Liver donors face a longer timeline: five to seven days in the hospital, four to six weeks off work, and up to six months before they feel fully themselves again. Lung, pancreas, and intestine donations generally fall somewhere in the liver donor range or longer, depending on the specific procedure and any complications.
Financial Support for Living Donors
The recipient’s insurance covers the donor’s surgery and medical costs, but lost wages and travel expenses can still create a financial burden. Several programs exist to help. The National Living Donor Assistance Center (NLDAC) can reimburse meals, travel, dependent care, and lost wages for donors who qualify. Your transplant team can check eligibility and apply on your behalf.
Other programs offer similar coverage depending on where you donate. The National Kidney Registry’s Donor Shield program automatically covers travel, meals, dependent care, and lost wages at participating centers. The Alliance for Paired Kidney Donation offers comparable benefits through its Donor Protect program. If you don’t have paid leave or short-term disability through your employer, these programs can fill the gap. The Meredith Haga Foundation also provides financial assistance for living expenses before or after donation.