Green September: seniors can also be living organ donors

In 2023, Arivaldo Sampaio, then 69 years old, watched his son lose the function of his only kidney after undergoing nearly daily hemodialysis. With a transplant as the only option, the entire family put themselves forward as possible donors – including Arivaldo. The result: a perfect match between father and son. According to the Ministry of Health, a living donor can donate one of their kidneys, part of the liver, part of the bone marrow, or part of the lungs, and blood compatibility is required in all cases. To donate an organ while alive, a physician must evaluate the donor's clinical history and previous illnesses, but age is not a limitation. "I had the happiness of discovering that I was compatible. That moment, for me, was a moment of grace. It was truly a divine grace," Arivaldo told Agência Brasil. He says he was anxious out of fear that the kidney might not be healthy. "I would ask myself, how is this kidney? Is it functioning well? Can it really be donated? We did all the tests and, thank God, I was deemed fit." According to Arivaldo, recovery after donating the organ to his son was smooth, especially because he was cared for by a highly qualified and very empathetic team. "My son left with the kidney already working." Three years later, Arivaldo has a routine of exercising at least five times a week, including running, weight training, and stretching. Once a year, he has consultations and exams at the University Hospital of Brasília (HUB), which coordinated the entire transplant process. "All of this is proof that when you take care of yourself, you can reach an older age with a better quality of life. I have a degree in physical education, I'm a teacher, I taught for 30 years in the public school system, and I always taught my students that our old age is the consequence of what we do beforehand, in our daily lives." Scenario In 2025, Brazil recorded 4,335 effective donors – a rate of 20.3 donors per million people, the highest number ever recorded. Even so, 49.4 thousand Brazilians are currently waiting in the transplant queue, according to data from the National Transplant System. In the case of living donors, Brazilian law allows donation among relatives up to the fourth degree, as well as spouses, without the need for judicial authorization. For people who do not have this degree of kinship, donation can also be carried out, but it depends on judicial authorization. Care Geraldo Freitas, a nephrologist at the HUB Transplant Unit, explained that, in the specific case of living donors, the evaluation is more careful, since its main objective is to ensure the safety of both the recipient and the donor. "After all, this is a healthy person who, voluntarily and altruistically, decides to donate one of their organs. Our goal is to minimize the risks of this procedure as much as possible and ensure that the donor can continue their life with safety and good health after the donation." When the living donor is over 60 years old, the analysis, according to the physician, tends to be even more careful regarding future risks arising from the removal of the organ. The evaluation is individualized and involves blood tests, urine tests, assessment of kidney function, imaging exams, and cardiovascular evaluation. "It's an interesting issue. On the one hand, with aging, the possibility of the person having conditions such as hypertension, diabetes, or cardiovascular problems increases, which can increase the risks of the surgery and of the donation itself." According to Freitas, the decision is based not only on numbers and involves the person's overall health, life expectancy, the possibility of the person remaining healthy with a single kidney, and also whether the risks of the surgery are acceptable. "It involves a complete evaluation of the donor." "At the same time, we also evaluate the recipient and the organ itself that will be donated, checking whether it is in adequate condition for the transplant and whether there is a good prospect of prolonged functioning after the surgery. In short, we need to find a balance: ensure that the donation is safe for the donor and that the organ offers a good prospect for the recipient." The physician emphasized that, on its own, advanced age does not represent an automatic exclusion from living donation, but as a person ages, there is a greater probability of developing conditions such as hypertension, diabetes, or changes in kidney function, requiring detailed investigation. "It is true that, with aging, the frequency of some diseases that may contraindicate donation increases. But when these diseases are absent, combined with adequate kidney function, and the medical evaluation shows that the individual is in good condition for the procedure, that person can be a donor."