Mandy and Paul McFarlane are the perfect match in every way – apart from their kidneys which only matched by one factor.
However, as Mandy was donating her kidney to her husband as a live procedure, it was still good enough for the transplant to go ahead and it has dramatically changed his life and future.
Mandy, 53, a paramedic with North West Ambulance Service based at Chorley Ambulance Station, says: “We were actually the worst possible match you can be while still being allowed to donate a kidney as I only had one factor that matched.
“However, as it was going to be a live donation, it did not matter.
“If I had been giving my kidney as a deceased donor, the transplant could not have gone ahead.”
Fiona and Paul, who live in Fulwood, Preston, and have been married for 31 years, discovered soon after their marriage that the day would come in the future when Paul would need a kidney transplant.
Paul’s dad Kevin had died of polycystic kidney disease but the couple had no idea it was an inherited condition until the genetic counselling service contacted them and asked Paul and his siblings to be tested.
Mandy recalls: “Paul’s father underwent two kidney transplants but neither of them worked. In those days, the success rate was not as high as transplants were more in their infancy.
“The success rate was about one in 10 in those days but, today, the failure rate is about one in 10.
“Improvements in surgery and the effectiveness of matching means that organ transplants are much more successful now.
“We found out Paul had polycystic kidney disease soon after we got married when he was about 26.
“We had no idea it was inherited so it was a massive shock.
“Paul was tested and he was positive for the disease, as was his older sister who had a successful transplant about 12 years ago. Paul also has a brother but he does not have the disease.
“We were both devastated when we found out Paul had the disease.
“I had known Paul’s father and seen him suffer so I knew what we could face in the future.
“Polycystic kidney disease is one of the most common causes of kidney failure. When patients get into their 50s, they will need a transplant as their kidneys will grow and become less effective and eventually fail.
“Paul’s diagnosis was a huge shock. But we thought: ‘Let’s just live our lives and get on with it.’
“However, the diagnosis did change Paul’s life as he decided he did not want to waste his life doing something he didn’t like.
“He was working for an energy cost analysis company but it was all about money and business.
“Paul wanted to do something more worthwhile and decided to go into teaching.
“It is the best thing he ever did as he loves it.”
Paul, who is deputy headteacher at Holy Cross Catholic School in Chorley, was fine and healthy for many years and was no different to anyone else.
He went skiing and played golf and he and Mandy had a son and daughter, Toby, now 26 and Lucy, now 23.
Mandy says: “We did everything normal couples do.
“But it was always there at the back of our minds.”
Paul had tests every year or two and, as the years progressed and he reached his 50s, he began feeling tired and they discovered his kidney function was starting to decline.
Then over the last few years, Paul’s kidney function went right down and he began to feel the effects and the couple knew the next steps were dialysis and going on the transplant waiting list.
Mandy read an article in the Lancashire Post about a wife who had given her kidney to her husband and thought: ‘I could do that!’
But when she broached the topic with Paul, he was resistant to the idea.
Paul explains: “I was against the idea as I did not think want Mandy to put herself at risk and I also didn’t think it was fair for both our lives to be put at risk when we had a son and a daughter.
“But Mandy was very pragmatic and told me she would be doing it for herself as well as for me. It was for us.
“We have both worked hard and done jobs in the public service and she wanted us to be in a position to enjoy our retirement.
“However, fundamentally, I know she did it for love.
“It was an absolutely lovely gesture from a magnificent person.”
Mandy says: “I told Paul: ‘If I give you my kidney, it will change my life, too, as otherwise I am going to have to watch you on dialysis and waiting for a transplant.’
“I had no doubt whatsoever that I wanted to give Paul a kidney. All the way through the process he kept saying: ‘If you don’t want to do it or change your mind, don’t worry.’
“But I was absolutely determined to do it.
“The only worry I had was whether I would be able to do it or not.”
Mandy went through lots of tests to see if she could be a donor for Paul.
Mandy had bowel cancer when she was in her 30s and had major surgery and, although she was given the all-clear in 2005, she was worried this might stop her being able to donate.
However, after going through lots of tests, she was found to be healthy enough to donate.
Mandy says: “We had separate medical teams looking after us. I had my own teams looking after my interests.”
A few months before the transplant, Paul had to have surgery to remove one of his kidneys to make room for his new kidney from Mandy.
Paul explains: “There was nowhere to put the new kidney so they had to operate to remove one of my kidneys.
“It weighed 5kg – which is like a bag of potatoes. Usually a kidney only weighs about 150g.
“Before the transplant, my kidney function had deteriorated to about 15 per cent.
“Then when I had one kidney removed, it went to about eight per cent so I ended up on dialysis.”
Mandy remembers: “Paul dealt with dialysis well but I found it devastating and heartbreaking.
“I wanted to give him a kidney so he wouldn’t have to go through that any more.”
The transplant went ahead on January 31 last year at Manchester Royal Infirmary and Mandy had surgery to remove one of her kidneys and then Paul had an operation to put it inside him.
Mandy says: “The day of the transplant was very emotional, particularly for our children who had to see both their parents go under the knife.
“I was up and out of bed first after the surgery and went to see Paul and it was a very emotional moment. We were both a bit shellshocked.”
Paul says: “As soon as I woke up after the transplant, I felt better straight away.
“I felt a ‘clean’ feeling with Mandy’s kidney inside me. It was as though someone had started scrubbing me clean inside and as though I had been flushed clean of toxins.”
Mandy says: “The hardest part was that I left hospital before Paul.
“I left after three days and it broke my heart as I did not want to leave Paul.
“Paul came home a couple of days later.
“We were both then at home recovering, which was strange as usually it is one or the other of you who is ill.
“Our friends, family and son and daughter were all so supportive.
“It was then just a case of recovery.”
Paul returned to work after three-and-a-half months and Mandy returned after five months as her recovery took longer and she felt very tired.
But now Mandy is back to normal and she and Paul are delighted as they will be celebrating their one year milestone since the transplant at the end of this month.
Mandy, who has been with North West Ambulance Service for 13 years, says: “I have absolutely no regrets and am delighted I gave Paul my kidney.
“I feel it is a great privilege to have been able to do it.”
When asked how it feels to have saved her husband’s life on top of saving lives every day in her role as a paramedic, Mandy modestly says: “My job is a privilege as you get access to people’s lives and help them at their most vulnerable.
“I feel this experience has given me a deeper understanding of serious and chronic illnesses.
“I learnt an awful lot about kidneys and this has improved my knowledge for my job.
“Reaching the one year milestone is a huge thing for us and I hope our luck holds out.
“Everything seems to be going really well and we hope it stays that way.
“I want to encourage other people to think about organ donation and to tell them that if they are able to do this for a family member or friend, they will be looked after really well.
“Giving Paul my kidney means he will be able to have a longer and more productive life.”
Paul says: “This was such an amazing thing for Mandy to do for me and I can’t put it into words how much it means to me.
“It is such a huge thing to do for someone.
“Mandy saves lives every day and she has now saved our lives in a different way by giving us the quality of life.
“It has made us a normal couple approaching retirement rather than the gloomy future we were facing.
“While dialysis is amazing, it is very time-consuming and restrictive.
“Everyone we dealt with in the NHS at Preston and Manchester was superb.
“At the last test, my kidney function was at 67 per cent.
“We are now looking forward to our future and enjoying our lives together.
“Mandy is a wonderful woman, a great wife and a superb mum.
“I am a very lucky man in more ways than one.”
Fiona Biggins, transplant recipient co-ordinator at Lancashire Teaching Hospitals NHS Foundation Trust, says: “Paul had a difficult couple of months, relating to his kidney failure, leading up to his transplant date a year ago
“It is a great pleasure to see how Paul and Mandy are now experiencing the benefits of kidney transplantation in enhancing the quality of both their lives.
“At Lancashire Teaching Hospitals NHS Foundation Trust, living kidney donation contributes to a third of all kidney transplants performed.
“Unfortunately, deceased organ donation numbers are very static.
“While the government have proposed increasing organ donation numbers in England, by implementing the opt-in/opt-out scheme recently adopted by Wales, this proposal is very much in its infancy with at present an inadequate infrastructure to follow through the proposal in the near future.
“Patients with kidney failure are highly dependent on the generosity of family and friends offering kidney donation to allow them to receive a transplant.”