On the morning of December 21st last year, I had a kidney removed in Belfast City Hospital. It was placed in an ice-filled cool box that had accompanied me to theatre and then “blue-lighted” to the airport. By the time I woke up in the recovery unit, it was on a chartered flight to a transplant centre somewhere in Scotland. By 5pm, thanks to the UK’s living kidney sharing programme, three people had a new kidney. The recipient of my kidney had a willing donor who was not a match for them so their donor’s kidney went to a second recipient and, in turn, that recipient’s non-matching donor gave a kidney to a patient on the waiting list.
The next day, I was up and about, clocking 2,000 steps in circles around the ward, admittedly at a glacial pace. The day after that, I was well enough to go home. I had a lazy Christmas; the only chore I did was to carve the turkey.
Otherwise, I mainly directed operations from the sofa. But by New Year’s Day, I had walked the South Wall in Ringsend, as per family tradition, and within another week I was walking 5km most days. I was back at work by the end of January. All in all, three nights in hospital, a week of some discomfort and a few weeks off work.
Admittedly, the “before” took longer than the “after”. A number of hospital visits over a period of months, every medical test under the sun and, finally, a mental health assessment (because the transplant service wants to be sure that the emotional impact of donating won’t be harmful to the donor). I ultimately had to do the mental health assessment twice – because my donation was delayed by Covid, the first psychological “pass” had expired.
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Why did I donate a kidney to a stranger? It started with an article that I read by chance in 2017. Before that, I hadn’t known it was possible (it’s still not possible in the Republic of Ireland, but hopefully that will change soon, following the recent passing of the Human Tissue Bill in Dáil Éireann; in the meantime, the transplant team in Belfast say they regularly get donors from the Republic). I also learned that kidney donation is easier and safer than I might intuitively have expected. And then a couple years later, when I was more than usually anxious about there being so much suffering in the world that I could do nothing about, I decided that this was one concrete thing that I could do to help at least one person.
I didn’t realise at the outset how useful a non-directed donor can be within the kidney transplant programme. Some people with kidney failure may not have a family member that meets the health criteria to allow them to donate. Others have family members or friends who would be able to donate, but don’t match well enough. Some patients have particular difficulties in finding a match. I was told that my recipient had been waiting for a match for some time.
The transplant team are at pains to tell you that you can change your mind about donating right up to the moment before you go into theatre but once I knew that this particular person was depending on my particular donation, there was no going back.
That’s not to say that I didn’t have any misgivings along the way. I had one special fear that I had shared only with the transplant consultant and no one else, not even my husband. I was afraid that I might not cope well with the post-operative pain. I was promised as much pain relief as I needed. And in the end, I was relieved to find that I was either lucky or a bit more resilient than I had given myself credit for. I was conscious in those first few post-op days that many people have to deal with much worse for far longer.
I know that I’m very fortunate. I’m healthy and I was in a position to take time off work for the assessment process and to recover. My husband and three adult children were supportive. It’s not an option for everyone, of course, but I think if it were more widely known about more people would want to donate. Maybe it could even become the norm that those who are in a position to donate do. It doesn’t seem to me to be that big a leap forward from blood donation.
I’ve never met the person who received my kidney. But I know that their surgery went well and that there is every chance that my kidney has significantly improved their quality of life. There is almost no impact on mine. I’ll need to have an annual check-up and I’ve been advised to avoid contact sports, including skydiving, so I’ve had to cross that off my bucket list! If you do a cost-benefit analysis, donating a kidney objectively offers a brilliant return on investment. I’m an actuary, which maybe made it a bit easier for me to weigh up the risks, which are very low and definitely a lot lower than having skydiving as a hobby.
Something that surprised me was the discomfort that I encountered in conversation with my wider family and friends and colleagues. Some people treated me like some sort of superhero, which I’m most definitely not. That made me uncomfortable. Others expressed or demonstrated their discomfort, either focusing on the possible risks or that the recipient was a stranger, or both. Perhaps because it’s relatively unusual, it seemed to them to be a bigger deal than it actually was. It’s not at all an extraordinary thing to do, just something that’s not yet ordinary. Many things that start off as unusual become commonplace over time.
I hope that we can make that happen with non-directed altruistic kidney donation too.