Why I donated a kidney to a stranger

One year ago I walked into an operating theatre, dressed in a tiny surgical nightie. Over the next three hours, through various keyhole incisions in my belly, my left kidney was cut from its pillow of protective suet and extracted from below the belt line. The kidney was rinsed through, put on ice and boxed up. It was then zoomed by car from my Bristol hospital to Birmingham, where a surgical team was waiting with a prepped male patient. Over the next few hours, the kidney was plumbed into the groin of a man whose name I still don’t know. He was in his forties and extremely ill.

That evening I was told by my transplant nurse that my kidney had begun its new life. Information about my recipient was scant but I was told that he had had a transplant before (I found that curiously upsetting news, as I had wrongly assumed that he must be a no--hoper) and was fiendishly hard to match. But I was his golden ticket.

Thanks to Covid, it had taken me more than a year and a half to donate. I was surprised I was eligible as I am in my sixties, I make wheezing noises when I get out of an armchair, and I am not teetotal. One or two friends wondered why anyone would want a pickled organ from the likes of me. In its defence, my kidney was described by the surgeon as ‘lovely and smooth’. My other kidney instantly took on the burden of its absent twin. Once home, I never noticed even a slight drop in water pressure.

News came last week that scientists have found a way of changing kidneys, irrespective of their blood type, into type O, the ‘universal donor’ blood group. It is great news as it will increase the supply of organs for people of rare blood types who spend years and years waiting while on dialysis – a form of life-preserving bondage. There are currently some 7,000 people waiting for transplants, the vast majority for a kidney. Hundreds of people die on the list each year. England changed the donation law in 2020 to an opt-out system in which consent is presumed; but there’s still a serious shortage of donors.

I would not have thought of making a living donation if my family hadn’t been on the receiving end. At the age of six our youngest son, Hal, who was born with serious disabilities, was diagnosed with chronic kidney disease. They slowly packed up. His regime of dialysis was incredibly fraught. We were told a transplant – and soon – was his only hope. We waited for many months. Then came the call – a matching kidney was waiting. The operation worked. He produced a Niagara of pee and didn’t stop. Hal slowly regained his life, his spark and his giggle. He had to take anti-rejection drugs every day but he sailed through the next 12 years as a new boy. His health, however, gradually collapsed in his late teens – nothing to do with his kidney. He died at the age of 20.

As we clung to the wreckage of his loss, we thought deeply about his transplant, a gift quite possibly from a young person whose family had turned their catastrophe into a huge bonus for mine. We had written to the donor’s grieving family (via the transplant service) but we never heard back. I had not been able to donate to my son but I naturally put my name on the on-line donor register as a form of payback. But then I started to think, if I really am going to donate, why wait until I’m dead? Living donations were common within families, ‘non-directed altruistic donation’ to strangers much rarer. And would I really miss a kidney? Reading up on it on the NHS website, the answer was no.

I had to think hard about the risks in order to sell the project to my family – we’d all been through such a lot. We agreed, though, that the odds are massively in the donor’s favour. Like low comedians, human organs often come in pairs. You only need one properly functioning kidney to lead a normal life. There is a one in 3,000 chance of dying during the operation, the same risk as having your appendix out. Your chances of dying are further reduced – dramatically so – if you are not overweight. My super-supportive wife suggested – demanded, actually – I shed a few kilos and got fit. I went on a diet of gym and Ryvita. The great bonus about the process is that you get an exhaustive medical over many months. Weird as it sounds, some studies suggest you are statistically likely to live longer if you donate, as anything rogue in your body will be discovered. Even better, you can go on drinking alcohol with just one kidney. It’s the liver that tackles the grape. Kidneys are filters operating further downstream.

I found the months of tests a lonely old business due to Covid. There were endless kidney function tests, blood and urine tests, screens, scans, heart traces and psychological evaluations; then, finally, an interview with a lady from the Human Tissue Authority to make sure I wasn’t being coerced into donating by the organ trafficking mafia. My designated psychologist was brilliant, making sure I knew what I was doing and why, reminding me I could pull out at any time. There’s also the sinking thought to consider – that donated kidneys occasional fail. How would that feel? The fear gathered as the op approached but I never found the nerve to do a runner.

I went home after two nights in hospital and basked in the sun. I did nothing but sip sweet green ginger wine and ice in a chair under my mulberry tree and read spy books. In the evenings, as a depressive counterweight to my drug-enhanced euphoria, I watched all the early films of Ingmar Bergman. A friend came to stay to help us out and I milked my convalescence. I got hero texts. One friend was honest enough to admit to being angry that I could even contemplate putting my family through such an ordeal. But the process closed a circle and put us as a family back in touch with our boy, whose absence filled the house. Donation was the best thing I have ever done. It’s a scientific miracle. The price to me was that of any major surgery: exhaustion, the effects of anaesthesia – Samuel Beckett’s line about ‘the sour cud and the iron stool’ sums it up – and ten weeks off work.

After a month I went back for a check-up with my surgeon. He showed me a disgusting, tropical-coloured screenshot. Metal spatulas held a substantial wound asunder. Snugly nesting inside was my yellow kidney just before its new owner was sewn up. The surgeon thanked me and this week, one year on, I got a NHS chrome pin badge for living donors that I’m proud of.

I haven’t heard a word from my guy and probably never will – for all I know, he may not read or write English. Recipients do get in touch with donors and I am sure it’s very emotional. But donor fantasies of weepy gratitude and a new friend for life are best parked early on. The anonymity is fine by me.

Living donation is hugely satisfying. I am amazed the NHS doesn’t big it up more. As for my remaining kidney, it isn’t complaining. How very weird it is to think of the other one doing its job inside a chap in the Birmingham area.