Navigating the Challenges of Living Kidney donation

Above, from R to L: Kari Rancourt, Living Donor Coordinator and nondirected kidney donor; Allison Marietta and her kidney transplant recipient, Mason; Jeff Moreau and his kidney transplant recipient, Oliver

Living kidney donation can be a transformative experience, but it’s not without challenges. On January 29, 2025, NKDO’s Engage webinar, “Complications and Challenges with Living Kidney Donation,” brought together a panel of donors to share their journeys—the good, the difficult, and everything in between. Moderated by NKDO’s Lisa Emmott, the session featured stories from Kari Rancourt, Allison Marietta, and Jeff Moreau, offering valuable lessons for current and future donors.

NKDO’s Engage webinars are free thanks to a generous contribution from Sanofi.

Watch the webinar recording here.
See our schedule of upcoming NKDO Engage events here.

Understanding Normal Recovery vs. Complications

Kari Rancourt, a living donor transplant coordinator at Hartford Hospital, kicked off the webinar with an overview of typical recovery. While most donors are discharged within 1-3 days and recover within a few weeks, every experience is unique. Like most major surgeries, it’s common to experience pain, fatigue, and even some depression during recovery.

Kari explained that temporary issues like surgical pain, post-anesthesia nausea, and constipation affect about 10-20% of donors. Major complications, such as hernias requiring additional surgery, are rare, impacting less than 3% of donors. Kari reassured attendees that most complications resolve fully with proper care, but it’s important to be prepared for the possibility.

She emphasized discussing potential complications and financial protections with your transplant team before donating. And if complications do occur, always work with your transplant center to address them, rather than seeking independent treatment and expecting reimbursement later.

Personal Stories of Overcoming Challenges

Kari Rancourt

Kari shared her story of becoming a nondirected donor just over two years ago. As a living donor coordinator, she knew the importance of proper recovery and planned for six weeks off work. After the surgery, Kari experienced severe nausea from general anesthesia, requiring an extra day in the hospital. Once home, her recovery seemed typical—until around the two-week mark when she noticed unusual abdominal swelling, loss of appetite, and feelings of restlessness and anxiety.

Kari contacted her surgeon and went to the emergency department, where a CT scan revealed a large fluid collection in her abdomen. She was diagnosed with a rare chyle leak, a disruption of the lymphatic system causing fat-processed fluids to accumulate internally. Treatment involved a second hospital stay longer than her initial stay for the donation surgery. A drain was inserted to remove the fluid, and she followed a zero-fat diet to stop fluid production. Over the next six weeks, Kari faced hydration challenges, fatigue, and weight loss, losing over 10% of her body weight before the leak resolved.

“Honestly, now that it’s all over, it sounds weird, but I’m actually really grateful for that experience,” Kari said. “It helps me understand the donors I work with even better and gave me a glimpse of what life can look like with health issues. It’s really easy to take your own good health for granted.”

“At the end of the day, my short-lived experience was a small price to pay for what I could do to help someone,” she said.

Allison Marietta

Next, Allison shared her journey after donating through a paired exchange to help the young son of close family friends. Initially, her recovery went better than expected, and she returned to work after six weeks, experiencing only mild fatigue. But two years later, Allison noticed a lump under her incision, which turned out to be a ventral incisional hernia requiring surgical repair with mesh. The hernia recovery was far more challenging than her donation recovery, with intense pain and a difficult healing process.

Unfortunately, this was just the beginning of Allison’s post-donation struggles. She developed an encapsulated seroma, a fluid-filled sac that had fused to the mesh from her hernia repair. Removing the seroma caused a tear in her abdominal wall, requiring additional mesh to repair the damage. Though she recovered from that procedure, she later noticed a bulge in her abdomen that required yet another surgery. Since that final procedure, Allison has fully recovered and is feeling “good as new,” she said.

“It was a challenging few years. I was an atypical donor, for sure,” Allison said. “Not everyone has my experience. But with each recovery I found strength in myself that I didn’t know existed. One thing that made it all worthwhile was [my recipient] Mason received the best kidney, and he recovered better than anyone anticipated. He’s living his best life.”

Jeff Moreau

Jeff Moreau, a high school physics teacher, shared his experience of donating to a young man from his church community. After surgery, Jeff experienced persistent abdominal pain that didn’t subside as expected. A CT scan revealed that he had an uncommon complication: the lining around his pancreas had become irritated from the surgery, causing digestive fluid to leak into the surrounding area. This led to a hospital readmission, where he underwent a drainage procedure.

Jeff’s recovery period stretched to five weeks, marked by discomfort, loss of appetite, weight loss, and mobility restrictions. Despite these uncommon difficulties, Jeff emphasized that the experience was absolutely worth it.

“The recipient is doing great, and it was a case where it was not looking good for him,” Jeff said. “In the end, would I trade five weeks of discomfort for somebody who can now continue on normally? It feels like a no brainer.”

Jeff’s story underscores the profound impact of living donation, even when rare complications arise for the donor.

Financial Protections and Emotional Support

The panel also discussed financial protections and emotional support for donors. Programs like Donor Shield (through the National Kidney Registry) and the National Living Donor Assistance Center (NLDAC) can help cover expenses related to complications. Kari stressed the importance of discussing potential complications and financial protections with your transplant center before donating.

Psychological impacts, including anxiety and depression, were also acknowledged as common post-donation experiences. The speakers encouraged donors to be honest with their healthcare teams about mental health concerns before and after donation and to seek support when needed.

Final Thoughts

While complications from living kidney donation are rare, being informed and prepared can make a significant difference. The experiences shared during the webinar underscore the resilience of donors and the life-changing impact their generosity has on people with life-threatening kidney disease. For those considering living kidney donation, these stories offer both caution and inspiration—reminders that even when challenges arise, the outcome can be deeply rewarding.

Click here to watch a recording of the webinar.