Could you give one of your organs to a stranger? When it comes to donating one of your kidneys, we can all understand the desire to help your child, partner, sibling or best friend in need. Perhaps more difficult to envisage is donating one of your kidneys to a complete stranger, someone you will never meet nor know for sure how much their life was changed by your gift.
Last week we celebrated living donor awareness week and ten years since the first altruistic kidney donation in Scotland. To date, 77 other Scots have also willingly undergone surgery to donate a kidney to a stranger. What motivates such an individual to come forward?
The story that will always stay with me is Emma’s. While she cared for her husband during the end of his life due to cancer she had wished it was possible for someone to tap her on the shoulder and whisper – we’ve had a call, everything is going to be alright. After reflection following his death, she decided to be an altruistic kidney donor so that she could be that ‘tap on the shoulder’ for a complete stranger.
For someone in need of a transplant, a kidney from a living donor is the best possible treatment. Life expectancy is enhanced and, as an additional benefit, the cost-saving for the NHS compared with dialysis is significant. Success rates are excellent, over 90 per cent of living donor kidney transplants are functioning at five years.
An altruistic donor started the kidney transplant chain for Julie. She desperately wanted a transplant so that she and her husband could look forward to a life free from the restrictions of dialysis, they hoped to start their own family. Many family members came forward but were found not to be suitable. Julie’s brother-in-law Steven came forward. He was not able to donate directly to her but they entered the national kidney sharing scheme. When a match was identified, Julie received a kidney from an altruistic donor and Steven donated on the same day to another person on the kidney transplant waiting list. Steven has returned to running marathons and I was so delighted to hear that Julie and her husband are now proud parents of a baby girl.
The UK kidney sharing scheme allows incompatible pairs to match up with other pairs around the country, opening the door to transplant for many difficult to match recipients. From January 2018, all altruistic donors are included in this matching, to start a chain of transplants – just like Julie’s chain.
I wonder about the altruistic donor though. They do not see the life-transforming difference their kidney made to Julie and all her family. Minimal information is shared – part of the anonymity agreement.
We learned a great deal from the stories publicised during living donor awareness week – the ‘secret smile’ of satisfaction that a donor has transformed a person’s life; the pride, the sense of well-being, the satisfaction in being able to do such an act of kindness and altruism for another.
So to all the people in Scotland who have donated to a loved one, over 800 in the past 10 years and a record 108 in 2018, and to the altruistic donors in Scotland over the past 10 years and those yet to come, thank you for being that tap on the shoulder for someone in need.
Dr Catherine Calderwood is Scotland’s Chief Medical Officer and she’s grateful to Jen Lumsdaine, living kidney transplant co-ordinator, and Dr Wendy Metcalfe for their contribution to this article.