Stories like that stay with you sometimes. In the 90s, I began donating blood after writing about the multitude of potentially life-saving ways blood from the collection of a single 470ml unit could be utilised. (Needless to say, I was extremely piqued when precautions against transmitting mad cow disease were brought in that excluded New Zealanders who’d lived in the UK between 1980 and 1996, although that restriction has just been lifted.)
When my father died in hospital after a massive stroke at the age of 88, his skin, his sclera (the white of the eye) and both his corneas were used to treat five different patients in need of donated tissue, including a man with severe burns and a toddler who’d had a growth removed from his eye. “Dad would have loved that,” I wrote at the time.
Donating a body part while you’re still alive is another level of altruism altogether. When my brother-in-law’s kidneys began to fail, irreversibly damaged by the type one diabetes he’d been diagnosed with at the age of 12, his sister, Julienne, told him to take one of hers. Roy refused to consider it.
“He wouldn’t even let me get a blood test to see if we were compatible,” she says. Two years later, his kidney function had deteriorated to the point where he was facing dialysis. He phoned her that night. “I hear you’ve got a spare kidney,” he said. “And I said, ‘You beauty!’”
It turned out they were a perfect match. When he died of other complications at the age of 68, after an extra 12 and a half years of good life, his doctor reckoned the only part of him that was still working properly was his kidney.
Being one organ short hasn’t made the slightest difference to Julienne, who was in her early 50s when she had the laparoscopic surgery and was back at work three weeks later. “It’s harder for the recipient to accept it than for the donor to give it,” she says. “But it’s just something you do if you can.”
Dr Ian Dittmer, a specialist physician with the Auckland Renal Transplant Group since the 90s, agrees patients facing kidney failure often feel uncomfortable about asking friends and relatives whether they’d consider being a donor. A more effective approach used now is holding whānau meetings where everybody comes together to discuss it as a group.
Improved treatments for infection and better immunosuppressants have seen the success rate skyrocket since the mid-80s, when half of all patients suffered acute rejection within the first 12 months. Today, 95 per cent of kidneys remain functioning a year later and half still work after 15 years.
In 2022, 174 kidney transplants were performed across New Zealand, including 70 from a live donor. Compensation for lost wages is available for up to 12 weeks on full pay - financial support that wasn’t available back in Julienne’s day. However, there’s still a huge gap between supply and demand. Most people on the waiting list for a kidney transplant will die before they get one.
A recent exchange programme set up with Australia has made it possible for organs to be packed in ice and transported across the Tasman if a live donor isn’t a compatible match with the intended recipient but still wants to gift a kidney, or a non-directed (altruistic) donor simply joins the general pool.
A battery of medical tests is required to evaluate suitability, including whether you’re likely to be able to live well with one kidney for the rest of your days (see donor.co.nz to find out more). Online tools are also available to calculate your own risk of developing end-stage renal disease, based on a range of health data including blood pressure, smoking history, BMI, urine albumin to creatinine ratio and eGFR score, a blood test that assesses renal function.
Right now, my projected risk of developing kidney failure in the next 15 years is 0.12 per cent. It’s not something I’m currently contemplating, but donating a kidney would elevate that risk by 0.27 per cent. Maybe that’s a statistic I could live with.
