A 1980s cult advertising campaign posed sharing your tube of cheap caramels as an existential crisis. A 21st century version of the dilemma involves higher stakes. Would you offer one of your kidneys to a member of your family? To a friend? To a stranger?
The first successful living donor kidney transplant was performed in 1954. The donor and recipient were identical twins. More than half a century later, you no longer need an exact match. Kidneys are commonly given by unrelated living donors. Transplants from living donors start work faster and last longer than any cadaver kidney. And end-stage renal failure is often predictable, so live donor transplants can be done before the patient needs dialysis, which improves the outcome.
No wonder that transplant units, despairing at seeing patients on the 8000-long UK waiting list die because there aren’t enough cadaver kidneys to meet the need, are keen to encourage living donation. It is something an increasing number of people do – around 1000 in the UK last year. So nearly half of renal transplants were from living donors. From spouses, blood relatives, friends, and some from unknown donors who offered a kidney to whoever needed it most.