https://consultqd.clevelandclinic.org/dual-organ-living-donation-how-cleveland-clinic-makes-it-work

Dual-Organ Living Donation: How Cleveland Clinic Makes It Work

Minimally invasive approach, peri- and postoperative protocols reduce risk and recovery time for these rare, magnanimous two-time donors

[/size]They're known in the medical literature as extreme living donors — people who have given two solid organs, either simultaneously or sequentially, to a transplant recipient or recipients. That's the technical term. Transplant surgeon C. H. David Kwon, MD, PhD, offers a more lyrical description."I call them people with a golden heart," says Dr. Kwon, Cleveland Clinic's Director of Minimally Invasive Liver Surgery. "They have a different attitude toward life and toward giving. They feel really happy to have helped someone. The action of giving gives back to the person who gives." Dual-organ living donation — usually involving a kidney and a liver segment or a kidney and distal pancreas — increases the availability of a scarce resource, reducing wait times for transplant recipients (often pediatric patients) and potentially saving more lives. But dual-organ donation remains exceptionally rare, due to the small number of people willing to undergo the demanding procurement procedure twice and transplant programs' mandate to minimize donor risks. A 2022 study using national transplant data identified 146 dual-organ living donors in the United States since 1994 — less than one-tenth of one percent of all transplants involving living donors during those 18 years.

[/size]Cleveland Clinic's extensive experience in transplantation and expertise in minimally invasive surgery, which reduces donors' postoperative pain and expedites recovery, facilitates dual-organ living donation. Since 2012, 22 dual-organ living donors have had one or both of their procurement surgeries at Cleveland Clinic.

[/size]"We have one of the largest series in the U.S. that I know of," Dr. Kwon says. "Altruistic donors come to us because we do minimally invasive surgery and because of our surgical expertise in utilizing the [smaller] left lobe of the liver."Left-lobe hemihepatectomy is safer for donors because it preserves a larger functional remnant but requires vigilant postoperative management of recipients due to the smaller graft size.

[/size]Cleveland Clinic has provided fully laparoscopic living donor hemihepatectomy for transplantation since 2019 with the arrival of Dr. Kwon, one of the world's most experienced laparoscopic living donor liver surgeons. The living donor liver transplant program under the direction of Koji Hashimoto, MD, PhD, has developed and demonstrated the efficacy of surgical modifications that lower the threshold for using small grafts, especially left-lobe grafts, without compromising organ functionality or transplant outcomes.

[/size]"Cleveland Clinic has been pioneering in this field, particularly in the minimally invasive approach for living donor surgery," says pediatric gastroenterologist and hepatologist Kadakkal Radhakrishnan, MD. "That's an area that needs expertise."

[/size]"We have observed, especially after we started our laparoscopic living donor program, that previous altruistic kidney donors want to donate a portion of their liver now," Dr. Kwon says. "And previous liver donors want to donate a kidney. It goes both ways."
...

Huge numbers opt out of Ireland's organ donation scheme in four days
https://www.thetimes.com/world/ireland-world/article/huge-numbers-opt-out-of-irelands-organ-donation-scheme-in-four-days-fl675zpsp

I've had the same discussion with my doctor. We agreed to leave the CKD in my medical record because... well... he has to.  :-[  But he made a note acknowledging that table is not for someone with one kidney.

Also, I've been keeping track of my kidney health biometrics for 20 years using a spreadsheet as evidence that it's been holding steady for decades: https://livingdonorsonline.org/kidney/afterwards/#:~:text=LDO%20created%20a-,personal%20worksheet,-listing%20the%20tests

Finally, I've captured lots of discussion on the issue of "low" GFR for living kidney donors in this message thread: https://livingdonorsonline.org/ldosmf/index.php?topic=7950.0 There might be information there to share with your primary care physician.

https://pubmed.ncbi.nlm.nih.gov/40523265/

Cadaveric Penile Microdissection and its Impact on Live Donor Penile Transplantation: an Experimental Case Series Study

Miroslav L Djordjevic et al.
[size=78%][/size] [size=78%][/size][size=78%]2025 Sep-Oct;51(5):e20250195. [/size][size=78%][/color]doi: 10.1590/S1677-5538.IBJU.2025.0195.[/size][size=78%][/color] DOI: [/size][size=78%]10.1590/S1677-5538.IBJU.2025.0195[/size]

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  Abstract
  Purpose: We evaluated the possibility of using remaining penile tissue such as preserved corpora cavernosa, the remaining glans tissue with neurovascular components and the anterior urethra, after femininizing gender affirmation surgery for live donor penile transplantation.
  Materials and methods: Between January 2022 and January 2024, penile dissection was performed in 31 male cadavers, aged 20-59 years (mean 42 years). The dissection with tissue preservation was based on penile disassembly principles: penile skin, part of the glans with neurovascular elements, and proximal urethra were prepared for feminizing genitoplasty while remaining penile tissue such as full corpora cavernosa, glans and anterior urethra were micro dissected and properly measured.
  Results: Mean penile length was 10.24 cm in the flaccid and 14.6 cm in the stretched state. The mean diameters of the deep dorsal vein and the right and left arteries were measured at 2.8 mm, 1.9 mm and 1.8 mm, respectively. Penile nerves with an anatomical distribution were found in all cases. The mean length and girth of cavernosum bodies were 19.24 cm, and 7.29 cm, respectively. The mean length of the distal urethra was 15.73 cm (range 11-21 cm), without registered anomalies. The mean volume of the glans after neoclitoris creation was 89% of total. All dissections were completed successfully, and all entities were joined again in all cadavers.
  Conclusions: The cadaveric study has confirmed the technical feasibility and possibilities of using all remaining penile tissue for possible live donor penile transplantation.Keywords: Gender-Affirming Surgery; Penis; Transplantation.
  
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https://optn.transplant.hrsa.gov/media/eavh5bf3/optn_policies.pdf

Of special interest are Policy 14, Living Donation, starting on page 280, and Policy 13, Kidney Paired Donation (KPD), starting on page 262. Make a checklist from these policies as this is the minimum information and actions all transplant hospitals are required to provide us.

I'm in very similar circumstances. After unsuccessfully trying to lower my cholesterol levels with diet and exercise (including going full vegan), my doctor prescribed a low dose (10mg) statin. My cholesterol level dropped almost in half! Fortunately (so far), there has been no negative impact on my kidney function: creatinine, albumin, and other metrics are holding steady.

I looked online and see there are some warnings about the use of statins and the impact on kidneys, but they appear to be associated with individuals who are "taking higher doses or in those with advanced CKD."

Of course (I say sarcastically), there are no studies of statins specific to living kidney donors.  >:(

Hope this helps.

I've gotten into heated debates with my doctors over this.   I'm also labeled as CKD III with GFR between 50 and 59.      I said, hey the kidney is healthy.   They said we have to go on the GFR.     Well, thank heavens the insurance company didn't boot me.   

Hi all - if there's a previous post on this I apologize.    The search engine kept failing when I tried to find it.

I donated a kidney about 17 years ago.      My GFR is running between 50 and 58 so they've tagged me as CKD III   even though it's a healthy kidney.      Anyway, cholestrol levels are good, BP was 112/78, resting pulse of 72.     I am heavy but exercise regularly.   

Here's the question - because of my age (73) the dr's risk factor shows me with a 16% chance of heart attack over the next 10 years, but believes he can lower that with statin usage.     I see side effects for statin usage include some kidney risk for those with CKD.      But given I'm a donor with a healthy kidney I don't believe that applies.   

Anyone here with an experience that could shed light on this?

Thanks

https://youtu.be/qOc2HuPtv3U?si=uukZGIftL-Rd0muq


  There's a sub genre of science fiction stories about humans being surprisingly dominant in the galaxy in some way in the far future. Sometimes the best have an interesting scenario, protagonist, or quality of our humanity that is revealed as exceptional. This one surprised me with a relentlessly, uncharacteristically cheerful protagonist in an unusual scenario, then really surprised me with a very positive inclusion of living organ donation and a great portrayal of family and friends' reactions when we tell them what we're doing!