How a father gave his kidney to a stranger to save his wife in incredible three-way donor swap

James Collins donated a kidney to help save his wife. But his kidney didn’t go to her – instead, the pair were involved in a three-way organ swap involving six patients, three hospitals and dozens of staff.

The UK Kidney Sharing Scheme connects donors who are unable to match with family members to people who can help them. Last year, more than 20 three-way organ swaps took place as part of the scheme which can see organs rushed by car, ambulance and even plane from hospital to hospital across the UK.

Mr Collins’s wife Claire was born with a rare kidney disease, and while he was not a match for his wife, doctors said they could be entered into the national database as a pair, with the hopes of finding other pairs that could match.

“With the shared scheme, it was a no-brainer: it wasn’t just Claire’s life we were impacting at that point,” he told The Independent.

There are more than 6,000 people on the waiting list for a kidney transplant in the UK, and the NHS Blood and Transplant’s associate medical director for living donations Lisa Burnapp said a kidney from a living donor like Mr Collins offered the best chance of successful transplant for people with end-stage kidney disease.

“The more people who are willing to consider donating in this way, the more kidneys there are available to help everyone waiting for a transplant,” she said.

Nearly one in three (27 per cent) kidney transplants are from a living donor, benefiting about 900 patients in the UK each year. In 2023-24, 185 of those transplants were performed through the living kidney sharing scheme, including 21 which were performed through a three-way exchange.

But getting those exchanges to work is no mean feat, said Joanna James, transplant coordinator at Leeds Teaching Hospitals NHS Trust, even once donors and recipients have been matched.

“There’s six people involved in some of these exchanges. So that’s potential of six patients in that period becoming unwell,” she told The Independent, adding that coordinating theatre space and staff between three hospitals is also tricky.

Professor Adnan Sharif, a consultant nephrologist and transplant physician at University Hospitals Birmingham, said when it does get confirmed he will be working with his transplant coordinator to make sure his donor operation happens at the right time.

“All the donor operations usually happen simultaneously, and we will not proceed until we’ve had the go-ahead,” he said.

Once the donor kidneys are removed, it is up to transport coordinators like Mrs James to ensure the organs are transported to the recipient’s hospital.

Mrs James said it can be a “nightmare” to coordinate, but added: “When it all comes together, it’s amazing.”

Prof Sharif said the scheme has been a “great success”, adding that it has also helped raise awareness of organ donation in general.

“We have a lot of pride in the scheme,” he said. “It’s ranked even by colleagues outside the UK, as probably the best one, I think, because it’s a national system and it’s very effective.

Former health minister Lord Ara Darzi who became patron of the  Robert Dangoor Partnership for Living Kidney Donation this week, said: “The incredible act of donating a kidney helps to significantly improve the lives of people with debilitating kidney disease, while also helping to ease the burden of kidney disease being felt by the NHS.”

Mr and Mrs Collins had their surgeries nearly six years ago. While Mr Collins said his life returned to normal after surgery, his wife’s life has improved immeasurably.

“The impact on Claire was immediate … she had more energy, she felt warm, she wasn’t tired, it was great to see,” he said.

“It has very little negative impact on the donor, but the person who’s receiving it, I can see the impact.”