A living-donor kidney transplant is when a kidney from a living donor is removed and placed into a recipient whose kidneys no longer function properly. 

Only one donated kidney is needed to replace two failed kidneys, which makes living-donor kidney transplant an alternative to deceased-donor kidney transplant. 

About one-third of all kidney transplants performed in the U.S. are living-donor kidney transplants. The other two-thirds involve a kidney from a deceased donor. 

Why it’s done 

Compared with deceased-donor kidney transplant, the benefits of living-donor kidney transplant include: 

Less time spent on a waiting list, which could prevent possible complications and deterioration of health of the recipient 

Potential avoidance of dialysis if it has not been initiated 

Better short- and long-term survival rates 

Your transplant may be scheduled in advance once your donor is approved versus an unscheduled, emergency transplant procedure with a deceased donor kidney 

The risks of living-donor kidney transplant are similar to those of deceased-donor kidney transplant. They include risks associated with the surgery, organ rejection and side effects of anti-rejection medications. 

What you can expect 

Living-donor kidney transplant usually involves a donated kidney from someone you know, such as a family member, friend or co-worker. Genetically related family members are most likely to be compatible living kidney donors. 

A living kidney donor may also be someone you don’t know, a non-directed living kidney donor. 

Both you and your living kidney donor will be evaluated to determine if the donor’s organ is a good match for you. In general, your blood and tissue types need to be compatible with the donor. 

However, even if your donor isn’t a match, in some cases a successful transplant may still be possible with additional medical treatment before and after transplant to desensitize your immune system and reduce the risk of rejection. 

If your living kidney donor isn’t compatible with you, your transplant center may offer you and your donor the chance to participate in the paired donation program. In paired living-organ donation, your donor gives a kidney to someone else who is compatible. Then you receive a compatible kidney from that recipient’s donor. 

Once you’ve been matched with a living kidney donor, the kidney transplant procedure will be scheduled in advance. The kidney donation surgery (donor nephrectomy), and your transplant typically occur on the same day. 

 Source: https://www.mayoclinic.org/tests-procedures/living-donor-kidney-transplant/pyc-20384838