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Overview
Most of the work of getting to surgery happens in the weeks before. The team will give you specific medical steps to follow: stopping certain medicines, eating well, and staying active. You will also arrange time off work, childcare or pet care if needed, and a support person to be with you.
On surgery day, the team takes over. Blood tests, imaging, and a meeting with the anesthesia team take an hour or two before the operation begins. Many donors describe a mix of nerves and purpose in those hours. You can change your mind right up until surgery starts, and the team will support you either way.
Before you arrive
Preparation begins weeks before surgery, not days. Your transplant team will give you specific instructions, but the general framework is similar across centers: optimize your health, arrange your life, and prepare emotionally.
Before you arrive
Medical preparation
In the weeks before surgery, medical optimization reduces surgical risk and improves recovery. Your transplant team will give you a pre-operative instruction sheet with specific details, but most donors follow these general guidelines:
Medication and health management:
- Fill all your regular medications and bring them to surgery
- Stop certain medications as instructed (typically blood thinners, aspirin, NSAIDs 5–7 days before)
- Control your blood pressure closely, aiming for <140/90 mmHg
- Attend all pre-operative appointments including final labs and EKG
Lifestyle optimization matters significantly in the weeks before surgery. Your body's condition going into surgery directly affects how well and how quickly you recover. Focus on basic health fundamentals: eat well, sleep well, and avoid illness.
Optimize your lifestyle:
- Maintain good nutrition with adequate protein to support healing
- Stay hydrated by drinking plenty of water throughout the day
- Exercise gently if you exercise regularly, maintaining cardiovascular fitness
- Stop smoking at least 4 weeks before surgery (ideally longer)
- Avoid alcohol for at least a week before surgery
- Get adequate sleep, aiming for 7–8 hours per night
- Avoid illness by limiting exposure to sick people and practicing good hygiene
These preparation steps directly improve your surgical outcomes and accelerate recovery. Follow all instructions from your transplant team carefully.
Personal preparation
Beyond medical preparation, you'll need to arrange your life to support recovery. Surgery means time away from work, help at home, and systems in place for basic needs. Plan ahead so you can focus on healing rather than logistics.
Practical arrangements to make:
- Arrange time off work for surgery and 6–8 weeks recovery
- Arrange childcare and pet care if needed
- Stock your home with easy-to-prepare meals or arrange meal prep/delivery
- Clean your home before surgery so you return to a clean space
- Arrange your bedroom with essentials within arm's reach (water, phone, medications)
- Arrange transportation from the hospital (someone must drive you home)
- Confirm your support person knows the surgery date and time and can be with you during recovery
The day of surgery
Surgery day brings a mix of practical steps and emotional intensity. You'll wake early, arrive at the hospital, and meet the surgical team one final time. Following pre-operative guidelines carefully helps reduce risk and sets you up for smooth anesthesia and faster recovery.
What to do on surgery morning:
- Nothing by mouth after midnight (NPO): no food or drink after midnight, including water
- Bathe or shower with antimicrobial soap the night before and morning of surgery
- Wear clean, loose-fitting clothes to the hospital
- Leave valuables at home or with your support person
Arrive at the hospital on time, typically 2 hours before your scheduled surgery. Plan to bring your ID, insurance cards, and a complete list of all medications and allergies. The pre-operative team will check your vital signs, start an IV, and review the surgical plan.
You'll meet the anesthesiologist to discuss anesthesia options and any concerns. You'll also have a final consultation with the surgeon to review the procedure and ask any last-minute questions. Bring entertainment if allowed (book, music, or phone) for the pre-operative waiting period. This is your final opportunity to discuss anything that concerns you before surgery begins.
Emotional readiness
The day before surgery, emotions often peak intensely. It's completely normal to experience a complex mix of feelings. Some donors feel excited and purposeful—they're about to give life. Others feel anxious and fearful about surgery risk. Many experience second thoughts or grief about permanent body changes.
Emotions you might feel include:
- Excitement and purpose about giving life
- Anxiety and fear about surgery, even though risks are low
- Second thoughts and doubt about your decision
- Grief or sadness about permanently changing your body
- Loneliness because this is ultimately your experience alone
You don't have to feel one particular way—and you can feel excited and terrified simultaneously. This emotional complexity is normal and doesn't mean anything is wrong with your decision.
If you're experiencing serious doubts the day before surgery, talk to someone you trust. Reach out to your support person, the independent donor advocate, or the transplant team. Doubts don't mean you have to cancel surgery, but they deserve to be heard and explored thoughtfully. Never feel pressured to proceed if you're truly not ready.
What your support person should know
Your primary support person (usually a family member or close friend) should understand:
- What to expect: Recovery is painful and takes weeks; you'll need real help
- Their role: Driving you home, helping with daily tasks, emotional support
- Realistic timeline: You'll be sore for 2–3 weeks; somewhat limited for 6 weeks; back to normal by 8–12 weeks
- When to call the doctor: Fever, excessive bleeding, increasing pain, difficulty urinating
- Their own needs: They should plan rest too; caregiving is tiring
- Your autonomy: If you change your mind about recovery plans, they should support that
Prepare your support person in advance. Have a planning conversation. Make sure they know what you need and feel comfortable asking for help.
Additional Detailed Information
Additional Information
Pre-operative medical optimization
Medication management. ACE inhibitors and beta-blockers are typically continued. Anticoagulation and NSAIDs are stopped 5–7 days pre-operatively. Corticosteroids may be adjusted. Specific instructions depend on the donor's medical history.
Pre-operative fasting. Standard NPO guidelines are 6 hours for clear liquids, 2 hours for beverages without food. This reduces aspiration risk during anesthesia.
Baseline labs. Final labs are typically obtained within 1 week of surgery and include CBC, comprehensive metabolic panel, coagulation studies, and infectious disease screening to ensure no interval change.
Cardiovascular optimization. For older donors or those with cardiac risk factors, perioperative beta-blockade (continuation of home beta-blocker) and statin therapy reduce cardiac events.
Pre-operative psychological preparation
Anticipatory anxiety. Pre-operative anxiety is normal and expected. Preparation and education reduce anxiety. Some donors benefit from relaxation techniques or brief counseling.
Surgical consent review. Informed consent is reaffirmed pre-operatively. Donors have final opportunity to ask questions or raise concerns.
Coping resources. Donors should identify and activate coping strategies (talking to support people, spirituality, journaling, meditation) in the pre-operative period.
Written By:
Transplants.org Staff
Last Reviewed: February 26, 2026
Informed By:
Transplants.org, with participation from 23 leading U.S. transplant centers, led the largest comparative analysis of patient educational materials in transplant history. We recognize the participating centers who helped inform and inspire our direction with initial patient-centered educational content:
- Mayo Clinic (Co-Author)
- Vanderbilt University Medical Center (Co-Author)
- Johns Hopkins Hospital (Co-Author)
- UCLA Medical Center (Co-Author)
- UCSF Medical Center (Co-Author)
Transplants.org is an independent nonprofit organization and participation is not an endorsement by these organizations.
