Britain’s oldest living organ donor
He’s 83 years old, but after his wife died, Nicholas Crace decided he wanted to give someone else a second chance. Here, he tells how he gave a kidney to a stranger in her 60s
Monday 31 December 2012
I cannot remember what put the idea of being a living kidney donor into my mind, but after my wife died last year I thought it might be worth investigating. I had been Brigid's full-time carer since she suffered a stroke in 2005. After she died I was kept busy sorting her affairs, but then came a lull and I was at a loose end, an unfamiliar experience.
Voluntary work did not fill the gap and at 83 it is hard to find appropriate volunteer jobs. I had been a blood donor all my life, but that ceases at 70. Donating bone marrow has a cut-off age of 40.
A call to a regional Renal Transplant Centre set in motion a sequence of events culminating seven months later in my gift of a kidney to a woman in her mid-60s. At times, I thought it was absurd an old man like me would be accepted as a donor, but such was the case.
Taking a kidney (nephrectomy) is a major operation and the risk of death is one in 3,000. The operation takes two to three hours and is carried out by consultants only (no mere registrars!). There are substantial risks of wound, urinary tract and chest infections. All these risks were made clear to me at the very start of the process that I undertook at the Portsmouth kidney unit based in Queen Alexandra Hospital.
The tests were daunting, comprising a kidney ultrasound, an ECG, a chest X-ray, a magnetic resonance angiogram, a nuclear medicine scan (one to three hours), glomerular filtration rate measurement (to find out how well the kidneys perform, 4.5 hours) and interviews with a psychiatrist and a Human Tissue Authority (HTA) assessor. There would also be a spell on the stress treadmill and an echocardiogram, designed to determine the overall health of the heart. And I would be fitted with a 24-hour blood-pressure monitor.
I became increasingly enthusiastic about the enterprise. I also felt, in view of the substantial cost involved in staff time and NHS cash, a great responsibility to see it through. The pressure on NHS resources meant that these tests were spread over five months, which for an impatient person like me was frustrating.
However fit I might be, were my kidneys suitable? Kidneys deteriorate over years, and for a transplant they must be at least 75 per cent efficient. It was gratifying to discover that I had – in the hospital's words – "Formula One kidneys". The finances of the whole process were fascinating. My evaluation as a prospective donor cost the hospital up to £4,000, and the removal of my kidney a further £12,000. But this expenditure would in fact save the NHS a great deal of money, as each patient on dialysis costs up to £29,000 a year, so apart from helping someone to live a reasonable sort of life I would also be making a useful contribution to the nation's finances, calculated at £200,000 over 10 years.
My visits to the hospital did not end with my being passed fit for surgery. I still had to be interviewed by an independent assessor appointed by the HTA. Under the Human Tissue Act (2004) the HTA must approve all transplants involving living donors, following an assessment by an independent assessor, who needs to be certain that the altruistic donor has been assessed and understands what is involved in the donation of a kidney to a stranger. The assessor appeared to be satisfied and four days later he emailed me to say that the HTA review panel had approved me.
An offer of my kidney was then made by the hospital to another transplant centre in South-east England. Unhappily, the cross-match of my blood with the prospective recipient's turned out to be unsatisfactory and the offer had to be rejected. Another offer was made – this time in the north of England to a woman in her mid-60s – which was accepted and I attended the hospital again to supply blood that was couriered off for another cross-match to be carried out. This turned out to be satisfactory and I was booked in for surgery a month later. So ended seven months of hope, excitement, frustration and some disappointment.
The operation (keyhole surgery) took over two hours and was uneventful and almost painless; I was in hospital for only four nights. Seven months after having made my initial enquiry I left Queen Alexandra Hospital, in high spirits with only one kidney. Two months later I had a letter of thanks from the recipient to say that my kidney had started to work straight away and that she was getting better and stronger day by day.
I am beginning to realise what a life-changing experience it has been. I have no children, but I have given someone life. I used to look upon myself as a relatively unemotional person, but now I find myself easily moved by some of the things that I have seen and some of the people that I have encountered.
I have been paid many compliments, genuinely meant I am sure, but to me undeserved, since what I did was so easy and required no courage on my part, as I found the whole process interesting.
The real heroes are those with failing kidneys – and their families. They put up with a miserable life coloured by perpetual illness, hoping all the time that one day they will win the lottery and get a new kidney.
When I realise how easy it could be to change their lives I feel ashamed that I did not think of donating a kidney long ago. And, like many donors before me, I wish that I had another one to give.
For information about kidney donation, go to giveakidney.org.uk
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