1. kidney, this is the most frequent type of living organ donation. For the donor, there is little risk in living with one kidney because the remaining kidney compensates to do the work of both kidneys.
2. liver, individuals can donate segments of the liver, which has the ability to regenerate the segment that was donated and regain full function.
3. pancreas, individuals can also donate a portion of the pancreas. Like the lung, the pancreas does not regenerate, but donors usually have no problems with reduced function.

Qualifications for Living Donors:
In order to qualify as a living donor, an individual must be physically fit, in good general health, and free from high blood pressure, diabetes, cancer, kidney disease, and heart disease. Individuals considered for living donation are usually between 18-60 years of age. Gender and race are not factors in determining a successful match. The living donor must first undergo a blood test to determine blood type compatibility with the recipient.

Blood Type Compatibility Chart

If the donor and recipient have compatible blood types, the donor undergoes a medical history review and a complete physical examination. The following tests may be performed:

          • Tissue Typing: the donor's blood is drawn for tissue typing of the white blood cells. 
          • Crossmatching: a blood test is done before the transplant to see if the potential recipient will react to 
           the donor organ. If the crossmatch is "positive," then the donor and patient are incompatible. If the crossmatch is
           "negative," then the transplant may proceed. Crossmatching is routinely performed for kidney and pancreas
            transplants. 
          • Antibody Screen: an antibody is a protein substance made by the body's immune system in response to an antigen
           (a foreign substance; for example, a transplanted organ, blood transfusion, virus, or pregnancy).
           Because the antibodies attack the transplanted organ, the antibody screen tests for panel reactive antibody (PRA).
           The white blood cells of the donor and the serum of the recipient are mixed to see if there are antibodies in
           the recipient that react with the antigens of the donor. 
          • Urine Tests: In the case of a kidney donation, urine samples are collected for 24 hours to assess the donor's
          kidney function.           
          • X-rays: A chest X-ray and an electrocardiogram (EKG) are performed to screen the donor for heart
          and lung disease.
          • Arteriogram: This final set of tests involves injecting a liquid that is visible under X-ray into the blood vessels
          to view the organ to be donated. This procedure is usually done on an outpatient basis, but in some cases
          it may require an overnight hospital stay. 
          • Psychiatric and/or psychological evaluation: The donor and the recipient may undergo a psychiatric
          and/or psychological evaluation.


Risks Involved in Living Donation
All patients experience some pain and discomfort after an operation. And as with any major operation, there are risks involved. It is possible for kidney donors to develop infections or bleeding and when a portion of the liver or pancreas is donated, the liver or spleen may be injured.

Living donation may also have long-term risks that may not be apparent in the short term. It is therefore important that the benefits to both donor and recipient outweigh the risks associated with the donation and transplantation of the living donor organ. In addition to potential individual health concerns, it is possible for negative psychological consequences to result from living donation. Living donors may feel pressured by their families into donating an organ and guilty if they are reluctant to go through with the procedure. Feelings of resentment may also occur if the recipient rejects the donated organ. Living donors must be made aware of the physical and psychological risks involved before they consent to donate an organ. They should discuss their feelings, questions and concerns with a transplant professional and/or social worker.

Positive Aspects of Living Donation



Living donation has several advantages:
• Living donation eliminates the recipient's need for placement on the national waiting list. Transplant surgery can be scheduled at a mutually-agreed upon time rather than performed as an emergency operation. Because the operation can be scheduled in advance, the recipient may begin taking immunosuppressant drugs two days before the operation. This decreases the risk of organ rejection.
• Transplants from living donors are often more successful, because there is a better tissue match between the living donor and the recipient. This higher rate of compatibility also decreases the risk of organ rejection.
• Perhaps the most important aspect of living donation is the psychological benefit. The recipient can experience positive feelings knowing that the gift came from a loved one or a caring stranger. The donor experiences the satisfaction of knowing that he or she has contributed to the improved health of the recipient.


• Deceased donor:

It means donation after death in the hospital by putting patients under a cardiopulmonary resuscitative machine until the approved consent from their families is obtained.

Brain death
Brain death is the complete and irreversible end of all brain function. Brain death is declared when medical tests confirm a complete loss of brain function, including the brain stem function.

So, what is brain death?
Brain death is a legal definition of death. It is the complete and irreversible cessation (stoppage) of all brain function. It is caused by severe trauma or injury to the brain, the body’s blood supply to the brain is blocked, the brain dies and it cannot be revived. It is permanent and cannot be reversed.

Brain death and coma
• Brain death is not the same as coma. A person can recover from a coma (brain activity and function is maintained) but brain death is permanent and cannot be reversed.
• An individual who is declared brain dead can be a potential candidate for donation based on certain criteria.
• An individual who dies because of cardiac death can donate tissues and corneas for transplant and under certain circumstances may be able to donate other organs for transplant.

It is usually new and unfamiliar experience for most families; it is helpful to have a clear understanding of what takes place if a loved one experiences brain death. Although this information certainly will not take away the sense of pain and loss, hopefully it will help you better understand what is happening with your loved one and enable you to make difficult, but necessary, decisions if faced with this situation.

Your loved one may look as if he or she is only sleeping. The ventilator fills the lungs with air and the heart monitor indicates that the heart is still beating. Your loved one may be warm to the touch and maintain normal facial color. However, in fact, your loved one is dead. Because without artificial help, the heart would stop beating and the lung will stop functioning within a short period of time.

1. Brain stem death because of head injury.

A cadaveric donor is considered not suitable to donate, if he/she is found to have:
• Loss of his organs due to the initial insult or due to shock lasting for more than 30 minutes, except for   corneal transplantation.

• Malignancy, confirmed or suspected (except primary brain tumor proved by brain biopsy and basal cell   carcinoma of skin). 

• Diseases of unknown etiology. 
• Malignant hypertension. 
• Insulin dependent diabetes mellitus. 
• Active generalized viral or bacterial infection. 
• HIV positive patients. 
• Narcotic addiction. 
• Untreated or inadequately treated systemic infection. Donation from deceased person can be accepted even if he/she is a hepatitis B virus HbsAg + ve and can be transplanted to patients with immune hepatitis, or having the same virus but not active. 

Note: 

• The decision is made for each case after consulting with the Saudi Center for Organ Transplant (SCOT). 
• When any hospital have a brain dead patient, they should inform and coordinate with the Saudi Center for Organ
Transplant (SCOT), the transplant unit and the intensive care unit to decide whether the organ can be transplanted   to another person or not. Most of the brain death donors are still attached to the ventilator until the organ is   harvested. Organ donation can only be done when approved consent from their families is obtained. If there is a   chance to donate an organ from a brain dead person; his family has to make their decision very quickly because the delay could result in a failure of the other organs like lungs, kidney, liver and heart. Therefore, one donor can help at least 10 other patients.