Yes, there are medical risks that anyone thinking about being a living organ donor should seriously consider: This is particularly true for living liver donors.

Living Kidney Donors:

The risk of death from being a living kidney donor is extremely low. Studies put it at .03 percent (three deaths for every 10,000 living donor surgeries). Nevertheless, with more than 5,000 living donor operations now being performed each year in the United States, the possibilities of something very tragic occurring are not zero.

Until a few years ago, most living donor kidney surgeries involved a surgical incision around the donor's back and side. This was by any standard a major operation, although one performed with a low level of risk to the donor and a procedure which enabled surgeons to remove the kidney in optimum condition for the transplant.

Now, many major medical centers use laparoscopic surgery -- which requires a much smaller incision and significantly shortens the post-operative recovery time for the donor. In laparoscopic surgery, instruments are inserted into the body through a series of small incisions and a surgeon manipulates them using a camera to extract the kidney. In a very small percentage of kidney donor surgeries, unexpected situations force surgeons to convert a laparoscopic surgery to an open surgery during the operation.

All kidney donors experience some pain and discomfort after surgery -- which is managed through medication -- and it is possible for kidney donors to develop infections or bleeding.

Since the kidney is close to the lung, there is a small risk that the pleura -- the space around the lung -- may be inadvertantly opened during surgery. If this occurs, it may become necessary to insert a tube in the chest to keep the lung inflated. The tube is then removed after surgery.

As with any surgery, there is always an element of risk with anesthesia, and doctors also take precautions in an effort to prevent blood clots in the legs.

But on the whole, morbidity from living kidney donor surgery is relatively low.

Living Liver Donors:

The risk of death from being a living liver donor is estimated at less than 1 percent, and that risk -- for a person who is otherwise healthy -- must be viewed as very significant.

Only one death of a living liver donor has been reported in the United States, but several are believed to have occurred in Europe. Doctors from the University of Chicago recently referred to reports of as many as six donor deaths, and said "on the basis of discussions at professional meetings, as compared with reports in the literature, we are concerned that some centers may not be reporting deaths in a timely manner."

Morbidity attributable to the living donor liver operation is estimated at 40 percent or greater, but most of this is minor.

However, the surgical process of removing a portion of the liver creates the risk that a bile duct leak will occur. There is also the possibility of damage to such nearby organs and tissues as the spleen or bowel. These could require another surgery to repair.

Minor wound infections are the more common. As with any surgery, there is always an element of risk with anesthesia, and doctors also take precautions in an effort to prevent blood clots in the legs.

For a person considering being a living liver donor, you would be well advised to be sure that the surgical team that will be operating on you has a high experience level in this procedure.

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