Donating a Kidney to a Stranger

Choosing to donate a kidney to a stranger is a selfless act, but Leigh Anne Mixon knew it was what she needed to do. Having spent more than a decade working on the administrative side of hospital transplant programs, she knows the statistics about the waiting lists for kidneys. And as vice president for the Froedtert & the Medical College of Wisconsin Transplant Program, Leigh Anne has intimate knowledge of what it takes to become a living donor. 

Making the Decision to Donate 

While a donor nephrectomy (kidney removal) is a major surgery, the procedure is relatively low risk. After donating a kidney, the remaining kidney will adapt. Once healed, a living donor usually has about 70% remaining kidney function. 

“Your body functions optimally with two kidneys, but it also functions very well with just one,” Leigh Anne said. “I knew if I could have such a positive impact on someone’s life without detriment to myself, I wanted to do it.”

 Leigh Anne had been contemplating becoming a living kidney donor for several years. She has friends and colleagues who donated a kidney and always felt encouraged by their experiences. She distinctly remembers the moment she knew she was moving forward with the decision. In July 2024, Leigh Anne attended the Transplant Games of America in Birmingham, Alabama. Thousands of transplant recipients, living donors and deceased donor families from across the nation came together for six days of sports competition and special events to celebrate and raise awareness for organ donation and transplantation. 

“Even though we have that organ donor box checked on our driver’s license, most of us don’t die in a way that we are actually going to be able to donate our organs,” Leigh Anne said. “Seeing firsthand the life-changing impact organ and tissue donation had for so many, I knew I needed to do something more.” 

As soon as she came home from the trip, Leigh Anne told her parents and close friends that she wanted to become a living kidney donor. Then, she started the evaluation process. 

Living Donor Evaluation 

For all potential living kidney donors, the first step is the evaluation. The hospital transplant team first needs to make sure the potential donor is healthy enough to donate a kidney. There are also certain health conditions or other circumstances that could disqualify a person from becoming a living donor. 

The evaluation is typically a full day of clinic appointments and includes a thorough health history, blood and urine testing, imaging, an EKG and a psychosocial evaluation. An independent living donor advocate is assigned to the potential donor to support the donor throughout and help with understanding the process, risks and benefits. The living donor can choose to end the process with no questions asked at any point during the evaluation, even once they are approved, and all the way up to the surgery. 

If the donor is approved, the transplant team tests to determine compatibility between the donor and the intended recipient for a directed donation. Should tests show the donor and intended recipient are not compatible, there is an option to do a paired exchange through the National Kidney Registry (NKR) or through the United Network for Organ Sharing (UNOS).  A paired exchange involves pairs of donors and recipients. When the donor and recipient from one pair are not compatible, they are matched with another pair. Kidney exchanges can become more complex, with more donors, including non-directed donors and more recipients involved. 

Benefits of Non-Directed Kidney Donation 

A non-directed donor is a person who donates to a stranger, not to a family member or friend in need of a kidney. This was the case for Leigh Anne, who did a non-directed donation through the NKR. It can take years for someone on a transplant list to be allocated a kidney from a deceased donor, but living kidney donors and kidney exchanges can significantly reduce the wait time to transplant. By donating through the NKR, Leigh Anne could take advantage of several benefits for living donors, such as the voucher program. 

“In cases of non-directed donation, the donor can name up to five family members who can be prioritized to receive a living kidney donation,” Leigh Anne said. “Also, all living donors that go through the NKR receive priority for a kidney should they ever need a transplant.” 

In addition to vouchers, the NKR offers reimbursement for lost wages, travel and dependent care. Leigh Anne would also benefit from the Froedtert & the Medical College of Wisconsin health network being a member of the American Society of Transplantation Living Donor Circle of Excellence, which supports employee benefits for living donors and reduces financial barriers to becoming a living donor by offering paid organ donor leave. Leigh Anne would not have to use any paid time off for the six weeks she would need to recover from surgery; her employer would reimburse the portion of her salary not covered by the Wisconsin Family and Medical Leave Act (FMLA). The recipient’s insurance would pay for all organ donation-related medical expenses. 

As a non-directed donor, Leigh Anne could choose a surgery date that worked best for her schedule. She completed her living donor evaluation at Froedtert Hospital, the academic medical center of the Froedtert & MCW health network, in September 2024, and scheduled her donor nephrectomy for Nov. 13, 2024. In the weeks leading up to the surgery, Leigh Anne spoke with other living donors who had been through the same experience. Because of her job, she already knew much more about kidney transplant than the average person, but she said it was an important step in her own personal preparations. 

“I got some very helpful insight in terms of what to expect for the recovery, especially with the timeline for going back to work,” Leigh Anne said. “And as a whole, I felt so comfortable with moving forward. The overwhelming statement from each person I spoke with was that they would donate a kidney again in a heartbeat if they could.” 

Expertise in Living Kidney Donor Care 

The week before her surgery, Leigh Anne had her preoperative appointment. After that, everything was on track for surgery. The donor nephrectomy is a minimally invasive procedure that is done laparoscopically or robotically with an incision that is 3-4 inches long and two smaller, keyhole-sized incisions. The living donor usually spends one night in the hospital to make sure their pain is well-controlled. They are usually fully recovered in 6-8 weeks. Living kidney donors go on to lead normal, healthy lives. Donating a kidney does not reduce life expectancy. In fact, studies have shown that living kidney donors tend to live longer than people who are not living kidney donors. This is likely because only healthy people can donate a kidney and because living kidney donors are more focused than the average person on leading a healthy lifestyle after donation. 

The transplant team at Froedtert Hospital is highly experienced in all forms of living donation cases, including donation of the left or right kidney and donation of kidneys that have complex anatomy. Emre Arpali, MD, PhD, transplant surgeon and MCW faculty member was Leigh Anne’s surgeon. Matthew Cooper, MD, transplant surgeon, MCW faculty member and Director of Solid Organ Transplant, transplanted Leigh Anne’s kidney into the recipient. Leigh Anne spent a couple of weeks after her procedure with her parents to have some help and company during her recovery. She returned to work part time after Christmas, and she came back full time in January. 

Leigh Anne may never know her recipient because the non-directed process is purposefully anonymous. For a living donor and recipient to meet, both must consent. Communication is typically coordinated by transplant center. Leigh Anne said she would be happy to meet her recipient if they would someday be interested, but she knows there can be complex emotions that come with the transplant process, and it may never happen. 

“Now, having been through the experience myself, I’m seeing my job through a different lens,” Leigh Anne said. “I learned so much. I feel so connected to the work that we do and the positive difference we can make.”