Almost 5,000 people are on the waiting list for a kidney transplant, but the number of living kidney donors in the UK fell to an eight-year low in 2017.
Carl Pinder is one member of a reasonably exclusive club after he decided to donate a kidney altruistically to a stranger.
“I was thinking: well, why not?” he remembers. “And I was trying to come up with reasons why not. And even up to the day I was thinking, why not? I never saw it as a serious operation, although everyone seemed to think it was. All I’ve got is three little scars.”
The donation on 15 February 2016 by Pinder, who was 58 at the time, started a process that changed two strangers’ lives. His organ went to Barbara Hallam, 68. Barbara’s daughter, who had wanted to donate to her mother but was not a match, gave her kidney to a four-year-old girl in Scotland. And all because Pinder thought: why not?
But even though he wears his sacrifice lightly and says he would do it again, the number of altruistic donations is down by more than one-fifth from a high of 110 in 2014 to 87 last year.
Figures released this week by the NHS show an overall decline in living kidney donation, with 990 donors in 2017 – the fewest in eight years.
Last year, 261 people died waiting for a kidney transplant, many of whom could have been saved through increased living kidney donation.
What is especially important about altruistic donations is that they can start chains of transplants. In Pinder and Hallam’s case, the chain had two links, but they can be up to three links long.
Hallam, from Sheffield, had spent four years on dialysis. After finding that neither of her daughters were compatible, doctors told them there was another option, donor-pair pooling, where they could be matched with another donor-recipient pair – if one could be found. “My daughter was quite keen to give her kidney to a stranger, so that I could get on to the altruistic list quicker and find a more compatible match,” she says.
The operation – keyhole surgery performed under general anaesthetic – takes about two or three hours and leaves a few small scars. It involves a hospital stay of several days and at least a month off work, but Pinder, who discharged himself early, makes light of it. “I won’t pretend it wasn’t sore; it was,” he says. “[But] two days later, I walked down to the village shop, which is about a mile away. Two weeks later, I was out gently jogging.”
Paul Gibbs, a transplant surgeon at Portsmouth Hospitals NHS trust and trustee of the Give A Kidney charity, says altruistic donors are similar to Pinder: they are typically over 55, have had a good life and are looking for a way to give back. “There’s just this group of people that feel they’ve got a spare part they don’t need and someone is in need of it,” Gibbs says. “They see it as a complete no-brainer.”
Candidates face a battery of tests to see whether they are suitable, not least psychologically. “It’s really just to ensure that they have understanding of what they are doing, understand their motivation and just to check that they’ve got the mental strength and social support to deal with not only the success, but also the failure,” says Gibbs.
There is no guarantee that an altruistic donor will ever hear from their recipient. But Pinder and Hallam agreed to eventually meet. “It was weird,” he says, recalling. “I was sat next to her talking to my kidney, as it were. I don’t quite know how to describe, it was sort of surreal, almost. But it was good.”
Hallam says she was nervous to meet Pinder, but his nonchalance and lack of fuss put her totally at ease. “I’ve not seen him again,” she says. “But we do keep in touch every so many months and find out how each other’s going on. I want to make sure that he knows that his kidney is absolutely top notch.”