By Anna Van Praagh – 10:30PM BST 23 Aug 2014
When Claire Ramsden heard a man on the radio describing a humbling act of altruism, she found it so moving that it wasn’t long before she was on the phone to the hospital to enquire about having the operation herself.
“I decided a few years ago not to have children,” says the 38-year-old psychologist from Preston, Lancashire, “and as part of reaching that conclusion, I thought, if I’m not going to create a life, why not try to save one? When I heard about kidney donation I thought, brilliant! This can be my contribution.”
The world may seem like an increasingly selfish place, but the announcement last week that there has been a dramatic rise in the number of altruistic kidney donors – people having a kidney removed and donating it to a complete stranger – was a moment of selfless good news.
Altruistic kidney donation has, in the past year, increased by 55 per cent, with 118 living people donating a kidney. The practice only became legal in 2006, and the following year only six procedures were recorded. Since then the numbers have risen exponentially.
Transplant experts believe that cases such as that of the 85-year-old woman who this year became Britain’s oldest living kidney donor – “Why do I need two kidneys to sit at home knitting and watching television?”, she asked – have inspired others to follow suit.
Before 2006, only family and close friends were allowed to give up their kidney for people suffering from kidney dysfunction. The authorities were wary of a trade in organs that could lead to an exploitative or coercive relationship between recipient and donor.
The current legislation, drawn to prevent this, states that donors are not allowed to know the identity of the recipient, although recipients are allowed to get in touch with donors, if they choose to, after the operation. This is so that the recipient is not made to feel any moral or financial obligation.
Like all donors, Claire underwent six months of rigorous tests at her local hospital to check that she was a suitable donor, including a psychological test to check her motivations. The final step was an interview with a representative from the Human Tissue Authority to make sure that she wasn’t being bribed or coerced. Once she had been approved, she received a call from the hospital within 48 hours to say they had found a match.
Typically, a kidney is removed by keyhole surgery in the abdomen under general anaesthetic and then transported to the recipient’s surgeon for transplantation. It is a major operation and Claire was only too aware of the dangers, which include blood clots, heart attack, bowel injury and infection, and results in one donor in every 3,000 dying during the procedure.
“A lot of people say you must be so brave,” Claire says, “but I’ve never been so scared in my life.”
Claire’s surgery took place at the Manchester Royal Infirmary in December last year. “The next day, I was told the transplant was a success, and I was just so delighted. I feel so privileged to have been able to have done it.”
Claire, who doesn’t know the recipient of her kidney, was discharged after three days and within five weeks was back at work. Now, she says, she feels better than ever, and only wishes she could do it again.
The kidneys are the body’s filtering system. They take waste products from the blood such as dead cells, extra salt and water, and excrete them in urine. Without medical intervention, kidney failure is fatal.
“Of the 6,000 people in need of a kidney in Britain, 300 can expect to die this year,” says Chris Burns-Cox, the co-founder of the charity Give a Kidney. “Humans only need one kidney to live a perfectly normal life, and donors can be aged between 20 and 80, so there are millions of people walking around with the potential to save a life.”
Burns-Cox, 76, a former consultant physician from Wotton-under-Edge in Gloucestershire, donated a kidney in 2010 and founded the charity the same year.
“I spent a lot of time growing up with my grandfather, who had made a lot of money and gave a lot away,” he says. “My father was an Anglican parish priest and my mother was an archetypal vicar’s wife, so I grew up in a family that liked to do good things, and I still do. My wife wasn’t terribly keen on me giving away a kidney, but she tolerated it.”
Like many people who donate a kidney, Burns-Cox found that the people who reacted most oddly to his act of altruism were his friends. “Once I told them, a deadly hush descended – it was very odd. I think some of them felt guilty they weren’t doing it themselves. Then as soon as I told one friend, a fellow doctor I had worked with in Gaza, and a very marvellous character, he went and did it straight away. It’s so obviously the most useful thing you can do.”
Weeks after the operation, Burns-Cox, like many donors, received a letter of thanks from his recipient, Michael Benton. “I do not know where to start to express my gratitude for your magnificent gesture,” it said. “Thank you, thank you, thank you.”
Benton, 72, a retired IT specialist from Christchurch, Dorset, was born with a kidney disease that had worsened throughout his life. Like everyone who suffers with kidney problems, Michael was put on dialysis once his kidney function fell below 10 per cent.
“The NHS provided a dialysis machine that worked as I slept by removing waste products through a tube in my peritoneum,” says Michael. “I was still working at the time and I was terribly tired. I was on dialysis for three years, and you gradually fade away. It puts a lot of pressure on your organs and your body deteriorates quite rapidly. I was in my mid-sixties and my life expectancy on dialysis was six years. I was seriously considering getting to 70 and then just giving up.”
Then, one rainy day, as Michael was racing his beloved model sailing boats on his local pond, he got a call from Southmead Hospital in Bristol to say they had a kidney for him. “All of a sudden, your entire life opens up again. It’s like a rebirth,” he says.
Since the operation in January 2010, Michael has felt in optimal health – in fact he says he feels better now than ever before. “I can’t tell you the feelings of gratitude I feel towards the NHS and to Chris. He is the most wonderful person. It makes you look at your own life and think, what have I done?”
At 90 to 95 per cent, the success rate for transplants from living donors is better than that from deceased donors, which is 85 to 90 per cent. “You are much better off having a kidney from a living donor, even if the person donating it is a bit older,” says Mr Nizam Mamode, a consultant transplant surgeon at Guy’s and St Thomas’, London. “We recently took a kidney from an 81-year-old donor and gave it to a 45-year-old, and they now have excellent function from that kidney,” he says.
Each successful transplant saves the NHS an average of £20,000 a year, meaning that a single kidney donated could save up to £200,000 in the first 10 years. Somewhat perversely, while the kidney the donor keeps will then do the job of two, the recipient’s new kidney will only function for up to 25 years, after which they will need another.
No studies have yet been done on the profile of donors, but “a typical donor is old or retired, and a significant number donate after a bereavement”, says Mr Mamode.
A recent YouGov survey found that 11 per cent of the adult British population would consider giving their kidneys altruistically while they are alive. If just a small proportion of these came forward to donate, there would be enough available kidneys for every person in need of one in Britain.
Ruby Stapleton, 21, from Ormskirk in Lancashire, was born with reflux of the kidneys and spent her childhood in and out of hospital, starting dialysis at just 10 years old.
“I had a machine in my bedroom that worked at night,” she says, “it could be painful and kept me up a lot. If there’s a kink in the tubes, the alarm goes off, and it used to go off constantly. I hardly slept.”
Ruby’s mother also has kidney problems so couldn’t donate, and her father, a driver, gave her a kidney when she was 11, but it didn’t work.
When Ruby was 16, she caught an infection from the tube used for the peritoneal dialysis, so she was moved to haemodialysis, which uses a man-made membrane to filter waste and remove extra fluid from the blood. This is usually administered over three or four sessions a week in hospital and is even more taxing on the body.
“It drains you completely,” she says. “I slept all the time. My quality of life just completely went. The whole thing completely destroyed my childhood.
“When I was 18, the hospital called me to say that they had a kidney for me, but I didn’t get my hopes up. I thought they’d pull out, it seemed too good to be true.”
But the operation went ahead, and Ruby’s transplant in April 2011 was a success.
“From the moment I came round from the operation I have been a completely different person,” she says. “I got such a shock when I looked in a mirror the next day. I had never thought of myself as looking ill, but the difference in my eyes and my skin was incredible. My skin was glowing and my eyes, which had always been yellowish, were really bright. I’d never seen myself looking well. And I felt absolutely fantastic; I still do.”
When the hospital asked Ruby if she would like to contact her donor to thank him, she didn’t hesitate.
“There’s no way to describe my feelings of love and gratitude to my donor,” says Ruby, who is now studying criminal justice at Chester University and has taken up dancing. “Quite honestly, I think he is an angel.”
That donor was Christian Brazier, a 29-year-old who works in family intervention projects for Crawley council. Christian was donating blood one day and spotted some literature on kidney donation. “I do think about trying to help other people day to day,” he explains. “I like to think about what I’m contributing. Everyone has the potential to help someone else, and I wanted to do it.”
When Christian received a letter of thanks from Ruby, he was over the moon. “A few months later, Ruby invited me and my girlfriend to her house,” he says. “We were expecting just Ruby, but her entire family were there. Her mother gave me the biggest hug and her dad burst into tears. I was just embraced in this amazing wave of gratitude – it was one of the best experiences of my life.
“Giving Ruby my kidney doesn’t affect me day to day in any way,” he continues, “but sometimes I do stop and think that was a decent thing I did. I’m glad I contributed and gave something back. If I was to die tomorrow, I’d know I’d done something worthwhile.”
For more information on kidney donation, visit www.giveakidney.org