Should I donate a kidney to my friend?

I told her I would, but now I'm having second thoughts

Topics: Since You Asked, Medicine, kidney transplant, hospitals,

Should I donate a kidney to my friend? (Credit: Zach Trenholm/Salon)

Dear Cary,

A dear friend of many years has a kidney disease and will likely need a new kidney within a year or face dialysis or worse. She hasn’t had any luck being on the organ list.

I said that I would donate a kidney to her if we are a match. But now I’m realizing that I am actually very uncomfortable with the idea. I hate doctors and hospitals, and the idea of surgery except in the most dire circumstances freaks me out. Also, I think there’s a reason everyone has two kidneys; it’s not just a spare part.

I like to do things that are stressful to the kidneys such as drink coffee, get drunk now and then, trip on plants that are metabolized by the kidneys and liver (this is part of my spiritual practice). Do I say nothing and hope that, come March when she’s testing possible donors, we are not a match? Or do I strain the friendship by admitting to her that I have misgivings about my promise?

Willing Initially

Dear Willing Initially,

You did a good thing. You offered to help.

You may or may not be a compatible donor. But you said these words out of a genuine spirit of generosity and kindness. This is a pretty amazing thing about human beings — that we are inclined toward helping each other. It’s a good thing.

It may turn out that you are a match, but it’s statistically unlikely. “In the case of cousins, your chance of being identical is 1 in 16. In the case of a friend, then your chances vary depending on how common your HLA is,” according to this helpful booklet from Stanford’s Program in History and Philosophy of Science and Technology.

In either case, having second thoughts doesn’t mean you’re a bad person. To donate a kidney is a big thing and it’s natural to have second thoughts. So wait until it’s time for all the potential donors to be screened, and get screened, and then deal with it once you know if you’re a potential donor.

This question and answer page from the University of Maryland Medical Center is very informative. As is this one. 

Give yourself some credit. You spoke out of an impulse toward compassion and selflessness.



If you are indeed a match and you can’t go through with it, no one will fault you for it. But your initial impulse shows you have within you the capacity to help. It’s a precious thing. Think of the worldwide effect of such impulses, if they were carried out millions of times over. Think of the things we could solve if we honored these selfless impulses and our societies were organized to realize them. Think how much needless suffering could be stopped.

You say you use psychedelic plants as part of your spiritual practice. Perhaps one of these trips you can inquire of your spirit guides what is the right thing to do. But you needn’t decide yet. Wait. More will be revealed.

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