Dubbo, NSW, March 2021
Original story collected in March 2021:
Almost two years ago I started the process of being assessed to donate a kidney to my friend Martin. Martin has chronic renal failure as the result of an idiopathic (unknown cause) disease which has been progressively damaging his kidneys for the past several years. His condition is progressive and incurable and his specialists are hoping to give him a kidney from a living donor before he needs dialysis. I initially saw my GP who referred me to a renal physician who outlined the donation process. (potential donors have to have their own kidney specialist who doesn’t care for the potential recipient).
Almost two years ago I started the process of being assessed to donate a kidney to my friend Martin. Martin has chronic renal failure as the result of an idiopathic (unknown cause) disease which has been progressively damaging his kidneys for the past several years. His condition is progressive and incurable and his specialists are hoping to give him a kidney from a living donor before he needs dialysis. I initially saw my GP who referred me to a renal physician who outlined the donation process. (potential donors have to have their own kidney specialist who doesn’t care for the potential recipient).
My physician explained that I would have to be of above average health in order to qualify as a donor. He also explained that any relative coming forward would take precedence as a better donor. The renal transplant team started testing me in mid-2019 – initially blood tests then kidney scans, heart tests, tissue typing and so on. I was given a handbook for potential donors and shown a series of youtube videos by Kidney Australia about the process including interviews with donors, recipients and the various members of the transplant team.
Due to COVID-19 the transplant team shut down for several months last year (2020). When they got started again I was contacted by the team about continuing the process of donor assessment.
A date for the transplant was set for March 10th 2021. I attended the transplant clinic in Sydney in late February for a series of meetings with various members of the transplant team. I underwent a stringent psychological assessment to ensure that I understood the risks involved and could meaningfully consent to the procedure. The team psychologist felt I was competent and commented that I sounded highly resilient – an important quality in what was ahead. My wife and I were then taken through a powerpoint presentation about the transplant process by the transplant coordinator. I was then examined by the renal physician associated with the transplant team. He requested some further testing be performed and deferred the March date as a result.
We met with the surgical registrar who talked us through the surgery and again outlined possible complications. Finally, we met with the Professor of surgery who would be performing the operations. He expressed some concerns about me as a donor.
On the right side the anatomy of the renal vessels was not suitable for the surgery and on the left side the kidney is substantially larger and is doing the majority of the workload. He felt he couldn’t operate on the right and was worried about taking the left kidney leaving me with an under-performing kidney. He explained that he would take his concerns to the team’s fortnightly meeting and let us know what they decide.
On the way home we stopped in to see Martin and his wife Sandy. They were incredibly gracious and grateful for all we had done to date. They expressed confidence that if I were to be ruled out as a donor then some better option would arise. We are still awaiting word from the transplant team.
For me the motivation it has been relatively simple – my good friend needs a kidney and I have two and only need one. In reality they’re not really “mine” – I didn’t create them and I don’t sustain them. I am given the job of temporary stewardship of my body and this seemed to me like an excellent use of a kidney. Martin and I met when we both moved to Brisbane to commence our medical degrees some 40 years ago. We lived in the same residential college and became instant friends sharing a love of sport and throwing ourselves into the fullness of university life together. We had both come from Christian families but it was in those years that we wrestled through exactly what we believed, why we believed it and most importantly, how to live out our faith in an integrated way.
If my surgical issues can be overcome and my donation goes ahead I will rest in the hands of a loving Father who has sustained me every day. If my role is simply to be a catalyst in the process then I trust that He has something better in store for Martin and myself.
Since we met with Martin and Sandy we have heard that his sister has decided to be assessed as a possible donor for Martin.
July 2022 update:
I was formally ruled out because of a combination of the particular anatomy of my renal vessels & the disproportionate workload (the kidney with the suitable vessels is doing most of the work of filtering my blood).
I was pretty devastated to be ruled out by what felt like a quirk of anatomy so close to the finish line. I remember replaying in my mind the psychologist's line about how resilient I seemed to be. I didn’t feel very resilient & could only imagine how Martin was feeling.
The professor reassured me that my efforts were not wasted but that maybe my role was to “get the ball rolling” and another donor would come forward possibly as a result of the work I’d done. Martin’s little sister did begin the process of being worked up but her tissue compatibility was (surprisingly) not great. I offered to speak with her about my experience of the process which took nearly two years thanks to COVID.
Then one night in late Feb Martin got a call from an unknown number. He assumed it was a telemarketer and hit the red button. They called again a couple more times & he did the same thing before finally blocking the number in frustration. Then at 3am his wife Sandy got a call – it was the renal transplant team saying they had a kidney for Martin and he needed to get to Sydney right away.
It turned out that this donor was a good match for Martin – much better than his own sister. He underwent the surgery & received the kidney that next morning. The surgery went well but the new kidney was slow to start filtering. Then around day 5 post-op, the new kidney “woke up” and started to work.
Martin and Sandy had to stay in Sydney for a few weeks for regular testing but the new kidney began functioning well. He was then able to stop dialysis and eventually to return home. He is on immunosuppressive drugs & has to be careful about his exposure to infection but he is back working a couple of short days in the surgery again.
We’ve visited them a few times & rejoiced with them about his great gift.
They have not been told anything about the donor but guess they were a young person possibly killed in a car accident. They were encouraged to write to the donor’s family which is something they did – expressing their gratitude while also acknowledging the family’s great loss.
It has been a formative experience for me – having to be a patient always makes us more aware of how we communicate and how patients are treated. Lots of my patients feel like they shared some of the journey with me and have asked about the outcome.
A few have said things like, “It sounds like a good thing to do but I wouldn’t do it”, but others have shared stories of their own attempts to donate organs – a couple of them successfully but also others who could relate to the disappointment of being ruled out. It’s not too hard to believe that the experience was valuable rather than wasted – even if that takes a little faith.