Discussing Living Donation

So how can you ask someone to consider donating a kidney to you? Again, our team will work with you to develop a strategy that meets your needs. But in general, you might consider the following approaches that some of our patients have found useful:

• Bring family members and friends together for a single meeting at your home. At this meeting, tell everyone about your kidney disease, why the doctors feel that a kidney transplant is your best option, and why your doctors are recommending a living donor kidney transplant. The advantage of this approach is that you can talk to everyone at the same time. You may like this idea, but find the group format too difficult or intimidating. Here at BIDMC, we offer our transplant patients the opportunity to have one of our health educators go to your home and meet with your family members and friends. Our transplant psychologist has done this quite a bit and most families find this to be very helpful. 
• Ask family members, friends, or others one at a time - individually - to consider donating a kidney. For instance, you might say:
  • "I have kidney disease and my doctors have told me that I need a kidney transplant to live longer and to improve my quality of life. The doctors said that a kidney from a living person is better than one from someone who has died. I know that this is a very difficult thing to ask, but would you consider donating a kidney to me? I don't need an answer right now, but it would be great if you would consider it. No matter what you decide, it's important for you to know that our relationship won't change at all, no matter what you decide."
• Give them a brochure that we will provide to you. The brochure has a lot of information about being a living donor, how the evaluation is done, and what past living donors have said about the experience 
• Write an email or letter and send it to all family members and friends. Again, you can describe your kidney disease and need for a transplant, while also mentioning that you would benefit from a living kidney donor. Our social worker or psychologist can help you with this letter, if it is something you want to try. 
• Find an "ambassador" who is willing to talk to others for you. This "ambassador" can be a family member, friend, pastor or other important person in your life.

One thing that we emphasize to our patients is that you should not decide who is medically eligible to be a living donor - that is our job. Sometimes patients will not talk to a family member because they believe s/he would not be eligible to donate. Sometimes our patients are right, and sometimes they are not. For example, one of our patients did not ask his sister to be a donor because he thought she was too old (60 yrs old). But when we told him that there was no upper age limit to be a living donor, he asked his sister and she agreed to be evaluated. He now has one of his sister's kidney and they are both very happy about it! Remember, we carefully evaluate the potential donor's health history and risk for certain types of health problems in the future. We have a team of professionals - separate from yours - who evaluates each potential living donor and we consider their health above all else during the evaluation.

What happens after you have tried one (or more) of the strategies mentioned? Ask those who have expressed an interest to telephone our living donor nurse coordinator at 617-632-9700, and she will take it from there. She will do a brief telephone interview and answer whatever questions people may have about donation. If they are eligible to be evaluated further and they are still interested in donating, we will schedule an evaluation. We do a thorough evaluation to be sure the donor really wants to donate, is in good health and completely understands the donation process.

You may be thinking, "It's been a month since I talked to family members or friends, and I haven't heard back from anyone?" This is common. Being evaluated as a possible living donor is a decision that should be made after careful consideration - and after talking with loved ones about it. After a few weeks or so, we recommend that you ask the people you spoke to whether they have considered being a living donor. If they say, "No, I haven't really considered it yet," or "I just can't do it," thank them for their thoughtful consideration and then move on to others. It is very important to remember that there are many reasons why someone might not want to be a living donor. It does not mean that they do not care for you or do not love you. Reassure them that you do not think of them any differently and that your relationship is still very important to you. They will feel thankful that you did not pressure them to donate.