The moment Danielle Horton met her perfect match "Billy", it wasn't so much as love at first sight, but it was instantly life changing.
Billy, as Danielle dubbed him, was the third kidney she had been offered during her two years on the transplant waiting list, but the first that was a viable option for surgery.
Up until four months ago, she had been one of about 1,850 Australians on the waitlist for an organ transplant.
"The first two calls, I was quite upset because I wasn't able to take [the kidneys] because they were 70 years old," Danielle said.
When the third call came, it meant a frantic packing of bags and a 450-kilometre, "bittersweet" drive from her home in Mount Gambier, in South Australia's south-east, to Adelaide for surgery.
"You're grieving for a family because they've just lost a loved one," she said.
"You can get on the operating table, and all of a sudden, they [medical staff] go, 'No, sorry, we can't give it to you. There's something wrong with it'.
"You don't really know until you wake up that it's happened."
Dialysis a lifeline
Danielle first started dialysis in 2003 as her kidneys began failing, and by early 2020 she was spending four hours of every day hooked up to a dialysis machine to keep her alive.
"Billy", her donor kidney, was found to be a 95 per cent match and the surgery took place just before Christmas 2021.
Waking up after her three-and-a-half-hour transplant operation, Danielle said the change in her quality of life was immense and immediate.
"The brain fog just lifted."
Four months later, and despite taking extreme care with her health, Danielle caught COVID-19.
"'I was actually quite scared, because I've got no immune system," Danielle said.
"They completely wiped that the day that I got the transplant.
"Luckily, my specialist is wonderful and was able to organise in the Mount Gambier Hospital an infusion that I could have. So very, very lucky. It worked."
Transplants 'back on track'
That specialist was Toby Coates, director of Kidney and Pancreatic Islet Transplantation at the Royal Adelaide Hospital, who has treated Danielle throughout her illness.
He describes COVID-19 as a "huge issue" for donor recipients, as their immune system is suppressed by the drugs given to make the transplant work.
According to Australia's Organ and Tissue Authority, 2021 recorded a 7 per cent drop in the number of people receiving an organ transplant from the year prior.
However, 2021 also recorded the highest ever number of new registrations on the Australian Organ Donor Register, with about 350,000 people signing up – an increase of 87 per cent on 2020.
Professor Coates said most transplants – particularly those for kidneys – ceased for about six weeks at the start of the pandemic, but those were now "pretty much back on track".
New medicines
Vaccinations and new medications are helping medical teams to keep patients healthy.
"If people are vaccinated, the vaccines are actually very effective at providing immunity even if you've had a transplant," Professor Coates said.
"And not only that, but we've now got some fantastic new medications, one of which Danielle had, which can actually block the effect of the virus, if you're unfortunate enough to contract it, and you are immune suppressed.
"We're fortunate enough that we've got good suppliers of it. So if we get somebody who's immune suppressed, and they get COVID, and we get them early, within the first five days, giving this drug will stop it dead in its tracks, which is exactly what we want."
Professor Coates said a severely weakened immune system was something transplant recipients had to deal with their entire lives, but new treatments were helping.
"There are now some amazing new treatments that are coming on board for COVID-19," he said.
"One that is soon to be available in Australia will be a prophylactic treatment, so we'll be able to give something that will protect an immune-compromised patient for up to six months, from COVID, before it even happens."
The best time of your life, but the worst for someone else
As for the person who donated her new kidney, Danielle doesn't know their identity but hopes to eventually be able to write to their family.
"It's a hard thing to get your head around, just the fact that you know that it's the best time of your life, but it's also the worst time of somebody else's," she said.
"So you want to try to live your best life to let them live on for you as well, even though you know nothing about them, what their life was like, what they loved."
Danielle has a myriad of health challenges ahead – there is no cure for kidney disease.
She hopes her new organ will last her many years to come, though there's no guarantee.
But not having to spend four hours a day hooked up to a dialysis machine means more time with family and friends, and a brighter future.
"It's really amazing, just the amount of time. Unfortunately, there's a lot of housework now. No excuse for that," she said.
