Yesterday we had some good news - or bad news, depending on how you look at it. My wife, Rachel, has been given the green light to give me one of her kidneys.
Now there is nothing to stop us comprehending the baroque horror of the day in question. My wife will be put on a slab in an operating theatre at the Royal Free hospital in Hampstead. She will be opened up and a perfectly good kidney, which has hitherto led a somewhat charmed and untroubled life, will be surgically removed from her and transplanted into me. If I was 20 years younger and texting a friend about it, I would probably key in something like "OMFG".
Two weeks ago Rachel had a myriad of tests to gauge her kidney function and all-round health to see if she is fit enough to be a donor. It involved a whole day of being poked and pricked, injected with radioactive substances, and having her internal organs looked at with a CT scanner.
She is now a patient at the hospital in her own right and is in the care of her own team of doctors. So, when her name was called out in the renal unit where I have been a patient for 10 years, I was not allowed to go through with her into the consulting room to get the results.
It is very important to the hospital that they separate our care. Her doctors have to act in her best interests in terms of what it would mean for her to give up a kidney - and they have to be sure she is making the decision freely, understanding all the risks to her, without pressure from me.
They have to be sure I have put no financial inducement in place to persuade Rachel to part with one of her kidneys. But in a way there is a financial inducement to do a transplant, because at the moment the NHS keeps me alive via 20 hours a week on dialysis. This costs around £35,000 per patient a year, not to mention the cost of all the medication I am on. I have also been so ill that I have been unable to work properly for months now. With a new kidney I will be able to work again and do my bit to ease some of the NHS's financial burden.
The doctor told Rachel that she was in pretty good shape and that he saw no reason why she couldn't be a donor. He confirmed several things from her blood figures, some of which she knew and some she didn't. He was able to tell her, for instance, that she doesn't have, and never has had, syphilis. That was good to hear. But she has had glandular fever at some point in her life, which she didn't know about.
He also told her that one of her kidneys works slightly better than the other one, although there's not much in it and this is very normal. I will get the less good one, leaving her with the more effective of the two. The one she will be left with will get bigger and take on the work of the one that's missing. Over time, her remaining kidney function will get back up to about 75%.
We have living proof that donors suffer no long-term ill effects - my brother Tom, who gave me one of his kidneys back in 2002, is fine, although he jokes about now getting pissed after two pints of weak lager.
As Rachel and I would love to have children when I am well again, one thing we had worried about was whether there would be any impact on her ability to conceive or have a safe pregnancy. Although there is a risk of high blood pressure during pregnancy if you only have one kidney, the doctors assured her this could be controlled at the time and that, overall, it won't have any impact at all on our plans to start a family.
But there are obviously risks with the surgery, and doubts about the success of the transplant. This will be my second transplant, which is often not as successful as the first. Rachel and I are obviously not related, so there is a higher risk of rejection than if she was a perfect match. There is also a risk that Rachel's kidney could immediately clot when they transplant it. And, of course, the dreaded IgA nephropathy that wiped out my own kidneys, and now my brother's, could well return and do the same to Rachel's.
We have really had to weigh up whether or not it is worth putting Rachel and her family through all this. What if the kidney doesn't make it through the transplant? What if it fails a week afterwards? What if after only a couple of years I am back in end-stage renal failure again?
But it is something of a Hobson's choice. We have to take the best option available to us now and, much as it terrifies me, that involves Rachel giving me a kidney. This is a chance for both of us to have a new lease of life, as without it I wouldn't fancy my chances.
• If you haven't joined the Organ Donor Register you can do so here: uktransplant.org.uk.
