The news this week that Joe Brolly’s donation of a kidney had failed drew attention to amazing acts of generosity that take place regularly – and to the fact that most transplants are very successful
THE ISSUE OF live organ donation came to the fore this week through an act of selflessness between two friends. When the GAA pundit and former Derry footballer Joe Brolly heard that the only possibility for a kidney transplant for a fellow under-10s coach, Shane Finnegan, was through a live organ donor, he presented himself as a candidate. Finnegan had been waiting for a transplant for more than six years, and, given the waiting lists and the availability of organ donors, his chances were slim. So, given that most people can function perfectly well with one kidney, Brolly went through detailed screening that determined his organ would be a suitable match for Finnegan.
Unfortunately, although the transplanted organ functioned well initially, complications arose, and last weekend, after nine days, later the transplanted kidney had to be removed because of what medical staff called a “rare and unfortunate occurrence”. Both men are now recovering, and despite the setback they are expected to lead a public drive for more living organ donations in the near future.
The chances of a living organ donation being unsuccessful are about one in every 100 transplants. About 5 per cent of all transplants, living or deceased, are unsuccessful after the first year. The risk of death to a living donor as a result of the operation is one in 3,000, while the risk of a person donating a kidney and subsequently developing kidney failure themselves is one in 500.
Before any living organ donation is carried out, the potential donor must pass a series of medical and psychological tests to ensure they are of sound body and mind. Most living donors are back on their feet within six or eight weeks of surgery, and can continue living on one organ with no great hindrance to their daily life.
“It is a traumatic experience if it doesn’t work out, but Brolly needs to be admired for the gift of donation,” says Dr David Hickey, the director of transplantation at Beaumont Hospital in Dublin. “Living donors tend to live longer than the general population . . . It is so tightly screened, and you have to be in tip-top medical shape and assessed independently by the transplant team. Things can go wrong, and it happens in the best of places. It is a rare but well-reported occurrence.”
Richard Costello and his wife, Anna, who own the Locke Bar, a gastropub in Limerick, epitomise successful living organ donation. In early 2010, Richard, a former Munster rugby player, was diagnosed with acute kidney failure at the Mid-Western Regional Hospital. He began dialysis in May that year, and because he is 6ft 7in tall, he needed four or five hours of dialysis four times a week.
“There were no signs this was coming,” says Anna. “He had high blood pressure, but it all happened within a few weeks. When he went to hospital he was very unwell, and they said his kidneys were not working. My first response was, ‘Well, how do we get them working?’ ” Richard went on the transplant list, and Anna began to investigate becoming a living donor. “I went through medical and psychological reports led by a wonderful team in Beaumont Hospital,” she says. “It turned out I was a match, so we talked about it and I decided to proceed. My eldest boy was worried that both of us would be going into hospital at the same time, but we went ahead with it three months ago.”
The family has just returned from a break in Paris, and so far the transplant has proved a success, with Richard slowly regaining his strength and energy. “Because it wasn’t an anonymous organ donation, I did worry about my wife’s health as well as my own,” says Richard. “She made the decision totally on her own, and we had our own separate medical teams in Beaumont.”
Has the transplant changed the couple’s relationship? “I am very grateful to her and the family,” Richard says. “They’ll be getting plenty of Christmas presents this year. Dialysis was very difficult, and I feel like I am returning to normal. She gave me the gift of life, and it is an unbelievable gift to get from anyone.”
VIVIENNE TRAYNOR, a legal-affairs reporter at RTÉ and a mother of four, donated a kidney to her nephew Martin in 2009, after he suffered renal failure and she had just had her third child. “I came into the picture when I saw Martin beginning to get frustrated with the system and the way the waiting list operates,” she says. “I suppose I, like many people, didn’t realise how tough it is to be on dialysis. When it became apparent I could survive on one kidney, and this person desperately needed one, then why not? It was a case of the more knowledge you had, the more it made sense.”
It took eight or 10 weeks for Traynor to recover, and besides taking care with certain medication, she says there has been no impact on her health. “Thankfully it was a success. If it had failed and he had rejected the kidney, I would have been devastated for him, just as I’m sure Joe Brolly is. I had to make a decision that once it left my body it was no longer my kidney. That’s how I planned to deal with it if things hadn’t worked out.”
Her act also brought complicated emotions. “You think, Do I need to hang on to my kidneys in case one of my own children needs one? The way I looked at it was that Martin’s own mother was not a match for him, so there was no certainty that I would be a match for my children.”
The process has brought her closer to her nephew, particularly as they spent so much time together before, during and after the operation. “I was very close to his parents, and he and I weren’t particularly close before this,” says Traynor. “We have a real closeness now, and we stay in touch a lot more. He is doing really well, and thankfully the hospital visits are less and less frequent.”
ANOTHER FAMILY to have emerged successfully from a living organ donation are the O’Gormans from Lismore. When he was seven years old Oisín O’Gorman fell off his bicycle and lacerated his kidney, which then had to be removed. During that surgery the medical team discovered that Oisín had been born with only one kidney, and he then had to go on dialysis.
When it later turned out that his father, Kieran, was a match for him, they went ahead with a living organ donation in June 2009, when Oisín was almost eight. “I didn’t worry about myself at all once he was going to be okay,” says Kieran. “I knew I was healthy going into it, and I think the hardest part was that we were in two different hospitals: he was in Temple Street and I was in Beaumont.”
After some initial complications, the transplant was a success, and last year,, Oisín competed for Ireland at the World Transplant Games in Gothenburg, winning two gold medals.
“Living with one kidney is no change whatsoever,” says Kieran. “I just have a bit of a scar. The two of us are very alike and we get on, but we still have our rows like any father and son. He is not treated any differently to my other son. Like every father, he drives me up the walls, like I drove my father up the walls. He doesn’t get any special treatment, but every now and again, just out of the blue, he will say, ‘Dad, thanks for the kidney.’ ”
See www.ika.iefor more details. For organ donor cards, freetext DONOR to 50050, Locall 1890-543639 or download the Organ Donor E-card app from iTunes or Android Play
Donations calculations
About one live organ transplant in 100 fails.
At any one time, between 500 and 600 people are waiting for organ donations in Ireland. Kidneys are the most common living donations.
In some countries, partial living liver transplants are carried out and living lung transplants are at an experimental stage. A live pancreas donor programme was attempted in the US some decades ago, but it was later abandoned.
Dr David Hickey, who is the director of transplantation at Beaumont Hospital in Dublin and has carried out more than 1,500 kidney transplants, says the living organ donor programme restarted in Ireland only in recent years as, ironically, the reduction in road-traffic deaths has led to an increased demand for organs.
Of the 192 kidney transplant operations carried out in Ireland last year, 27, or 15 per cent, came from living donors. The EU average in 2011 was just over 20 per cent, although some countries do not have living donor programmes.
It is expected that about 180 kidney transplants will be carried out in Ireland this year, meaning there are significantly more patients than organs donated.
