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Living kidney donors: the special minority

15 July 2022

*Special thanks to Elissa Lawrence from QWeekend for writing the longer version of this story.  This has been adapted from her words.

Victoria Parker, 46, of Brisbane’s inner suburb of Auchenflower, said she had a moment of pure clarity the day she made the decision to donate one of her kidneys to the woman she was driving in her car, Aunty Robyn Williams.

Williams, 63, an Indigenous Yugambeh elder and community worker of Mount Warren Park, in Logan, had been on the transplant organ waiting list for about a year, suffering kidney failure as a symptom of diabetes. She underwent regular dialysis to stay alive.

The pair met as part of their work with a community organisation that creates opportunities for kids in the Logan area

After undergoing extensive physical and psychological testing for about a year, the four-hour operation to remove Parker’s kidney and transplant it into Williams was successfully performed in March 2021 at Princess Alexandra Hospital.

PA Hospital is currently the largest unit in Australia based on number of kidney transplants, performing between 160 and 200 each year, with about 30 of those coming from living donors. Diabetes is now the most common cause of kidney failure seen in new patients presenting to the PA.

PA kidney specialist Associate Professor Scott Campbell says living donors are “a special minority” with the most common donor relationships between spouses and partners, and parents to children.

“In the case of Robyn and Victoria, it was a case of two people who were friends where Robyn gained a very substantial health benefit from an extremely generous gift.

“Robyn is now free of dialysis, she has excellent kidney function and her quality of life is substantially better for that – as well as her life expectancy.”

A living donor operation is unique in that it is the only one performed in the hospital that doesn’t leave the person in better shape than they were before.

Donors face a small risk of complications that can include bleeding, infection and blood clots. The risk of death for the donor is estimated to be about one in 3000.

Campbell says without Parker’s donated kidney, Williams, who had already been on dialysis for a year, was likely to have waited at least another two years for a suitable kidney.

But patients also have to remain well enough to receive a donated organ. Williams’ underlying kidney disease was from diabetes, which can also lead to cardiovascular disease, stroke and damage to blood vessels.

“Dialysis is a wonderful treatment in that it keeps people with kidney failure alive … but it is extremely time consuming and inconvenient,” Campbell says.

“Even good dialysis only replaces about 10 per cent of your kidney function – enough to keep you feeling okay and keep you alive but it isn’t really a full substitute for all the work a healthy kidney does.

“After a transplant, people just feel like they have more energy, they feel more alive and well, they save huge amounts of time from not doing dialysis. They often get a better appetite and report that food starts to taste better again.

“They are able to get back to doing most of the things they used to be able to do before.

“A kidney transplant makes a major difference to people in their health, wellbeing and it improves their survival.”

Kidney transplants are the most common type of solid organ transplant, followed by liver, lung and heart.

Nationally, there are about 12,000 people on dialysis, including about 2000 in Queensland, who could benefit from a kidney transplant. In 2021, there were 202 living kidney donors out of 657 total kidney transplants.

In Australia last year, there were 1850 people on the waiting list for all transplants, with the average waiting time for a kidney being 3½ years.

Living kidney transplantation not only reduces the time a recipient will have to wait but often it also has better success rates. Typically a kidney from a deceased donor will last 14 to 15 years (though some patients in Queensland have transplants that have worked for more than 40 years). Living donor kidneys are expected to last about 18 to 19 years.

Aunty Robyn is now back working full time and embracing life “with a spring in my step”, amazed at how much livelier she feels.

“When I was sick, I didn’t realise I was that sick,” Williams says. “Now I can feel how much of a difference it has made, even looking back at photos of myself.

“I’m back at work full time and feeling great. I can do more things, I’m not so tired anymore. I’m not dragging my feet and people can hear it in my voice how much I’ve changed.

“The next day after the operation I felt really good. It is amazing how a new kidney could do that. It is amazing, it really is.

“Victoria and I are definitely sisters now. The stars just aligned. She’s just a wonderful, amazing person. It was a very special gift and I will never ever forget that. It’s something that I’ll treasure.

“I was so supported by Victoria but also from the Logan Hospital Renal Clinic and the PA Kidney Transplant Unit and also my workplace.

Assoc Prof Campbell says there are never quite enough kidneys to go around.

He encourages people to talk about organ donation and to register their interest in being a donor on the Australian Organ Donor Register: “It’s important for people to register their interest in being a donor but, also, if you are close to someone with kidney failure and you think you might be suitable and keen to donate a kidney to them, then mention it to them,” he says.

“Some people with kidney failure find it hard to raise this as an issue even with people quite close to them. The more people understand it, the easier it may be to have these conversations.”

In assessing compatibility for kidney transplants, doctors look at tissue typing, blood type and antibodies that may be present against other tissue types.

Over the past decade, with advancement in modern drugs, blood group incompatible transplants are now possible, allowing more transplants to occur. About 70 to 80 blood group incompatible transplants have been performed at the PA.

“Anyone who donates a kidney is very special. It’s also a special gift from people who have died and have agreed, or through their family agreed, to donate.

“All these people bring enormous health benefits and freedoms to patients who are otherwise leading an extremely restricted life on dialysis.

“This case of Victoria and Robyn shows the tremendous benefits that Robyn has been able to receive as the result of a generous gift. It is a very special thing to agree to undertake.”

Associate Professor Scott Campbell

Registering to be an organ and tissue donor only takes a minute, and all you need is your Medicare Card. Register today!   https://www.donatelife.gov.au/register-donor-today

Last updated 15 July 2022
Last reviewed 15 July 2022

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