A Rare Offering

"I don't think it's a big thing, but it's a big thing for the recipient. It's absolutely incredible to know that something that is actually an extra for me is working in somebody and letting them regain their life."
"I've had the comment 'But you could die'. Yeah, and I could be crossing the street and get hit by a bus. I don't believe you can live your life waiting to die. If something happens on the operating table, let them harvest everything they can."
"He [her surgeon] looked like a kid in a candy store; he said, 'It went great, the kidney has started to function [in the transplant patient] already.' The fact that you know you're helping someone get healthy is pretty amazing."
Annemieke Vanneste, kidney donor, Toronto General Hospital

"Many of these people are just remarkable people. They work in communities, they work in food banks, help disadvantaged people. ... This [altruistically offering a body organ] is just an extension of that."
Gary Levy, head, University Health Network multi-organ transplant program

"It's one of the most stressful operations I'm involved with. It's totally elective, totally voluntary, and you just want to make sure everything goes right."
Dr. Michael Robinette, transplant surgeon, Toronto General Hospital

"You can't even describe the gratitude -- she saved my life. It has given me a future. I do not consciously think 'How sick will I be in six months; will I be here next year?' I have been given a body that works again."
Kidney transplant recipient

Peter J. Thompson/National Post     Annemieke Vannest, left, laughs with sister Caroline Vannest and 

Dr. Michael Robinette as she prepares to head into her anonymous kidney donation operation at 

Toronto General Hospital.

This unnamed woman who received a kidney from 47-year-old Carolyn Vanneste is profoundly grateful to have her life back. Her donor is a woman who works in health-product regulation at Health Canada, and she had offered one of her kidneys. She had been inspired by her brother-in-law, Dr. Aubrey Goldstein who had undergone a life-saving liver transplant 16 years earlier which led him to become closely involved in the organ-recipient community.

The woman who expressed relief and joy at having a future is a nutritionist working with elite-level professional athletes. She had been on dialysis for seven years, and her condition had become acute in more recent months. Carolyn Vanneste's sister, Annemieke, was taken with the concept of offering such an intimate part of herself so that a stranger could look forward to an extended life, freed from their own failing organ, living with the aid of a generous and compassionate stranger.

Which was why she offered to part with one of her kidneys. It seems a strange thing to do, for most people to even contemplate; to undergo major surgery with all the risks that entails, to do a good deed for someone whom you have never met and likely never will, since donor and recipient are for the most part unknown to one another. The simple fact is that there are not enough cadaver-harvested organs to meet the demand of those whose health has failed them and whose only opportunity to prolong their lives is a donated organ.

Another fact appears to be that organs taken from living donors appear to be more efficacious and last longer than organs taken from people who have died, signing their organs away for harvesting. But living donations since 1954 once restricted to close family members were expanded to include friends. And then another concept was born: "chains", where recipients and donors who did not match donated to someone else and in turn a family member would receive an organ from someone else.

Now, dozens of people are coming forward offering an organ to help someone they don't know but who is desperately awaiting a replacement organ for their failed one. Transplant centres across Canada have seen a modest upsurge in offers, to the point where organs taken from living people now outnumber those harvested from cadavers. When a religious health group placed a call for a donor for a seriously ill child last year a 'flood' of nearly 200 volunteers responded.

Anonymous donors whose offers are accepted appear to reflect a personal history of altruistic behaviour; they give blood, they tend to volunteer for all kinds of charitable groups and they offer to help in their community. Many people seem to feel this is incumbent upon them as good citizens, others have been motivated by their own family situation with members having experienced organ failure. Some do it just to be better people and enhance their opinion of themselves.

A 2010 study looking at decades of acquired data suggested that three living kidney donors out of ten thousand die within 90 days of the operation; long-term mortality among donors appears no steeper than among non-donors. Those who decide to donate a piece of their liver face a higher chance of complications leading to death however, even though the liver is able to regenerate; about one in 300 living donors dies.

In Ontario alone the annual need amounts to 4,000 kidney and 1,400 liver transplants. The province can count on accessing at most about 450 donor organs yearly. The need is dire.