There is a room in Gloucestershire Royal Hospital that contains 30 kidney dialysis machines. Every four hours 30 patients leave and another 30 arrive for their four-hour life-saving treatment. It takes four hours for the blood of a single patient to pass through a machine and be cleansed of the toxins normally eliminated naturally by the kidneys. Two days later the same patients return for another four hours. The process is not painful but it is exhausting and leaves the patient feeling less well than before the start of the treatment. One Stroud woman was so moved by the suffering of her 23-year-old niece who had to endure this apparently endless cycle of treatment that two years ago she decided to make the tremendous gesture of donating one of her own healthy kidneys so that her niece could live a normal life again. Niece and aunt are now both well on the road to recovery and they talked to Skip Walker about their experiences)

WHEN Leyla Gardiner was just three years old she developed a kidney infection. Her immune system set to work, cleared up the infection but then went on to attack the kidneys themselves.

Twenty years later, in May 2001, Leyla's kidneys had been destroyed by her over-active immune system and the only way she could be kept alive was either by a kidney transplant or dialysis.

Her doctors were confident that with Leyla's common blood type a suitable donor would be found fairly quickly and she was put on the transplant list. Months went by, however, and no suitable donor came forward.

Often immediate family members can prove a good tissue match but in Leyla's case her mother was a different blood group, her father had health problems that prevented him from becoming a donor and her brother was too young.

By January of last year her health had deteriorated to such an extent that the doctors had no option but to put her on dialysis.

Not only did this mean she would have to travel to the hospital in Gloucester three times a week for the four-hour treatment but Leyla also had to have three fairly major operations to her arms to prepare her for the dialysis.

From this point her life degenerated. Dialysis does not suit every patient and Leyla found she felt lousy after the treatment.

"I used to go in feeling fine and come out feeling terrible," she said. "I would be dehydrated, sick, dizzy and feel like that for the rest of the day and night."

She had to give up her job, had virtually no social life, had to live on a very restricted diet and if she continued on dialysis it would have made it impossible for her to have had a baby.

"Being on dialysis was just like being in limbo," she said, "constantly waiting for the day you have a transplant."

On top of all that, four of her fellow sufferers at Gloucester died during the year Leyla was on dialysis.

It was at this point that a more distant member of the family, her father's sister, Pam Chamberlain, offered to be tested as a kidney donor.

"I already knew that I was the same blood group as Leyla and she had been on the transplant list for so long that I felt I had to do what I could to help," said Pam from her France Lynch home this week.

For most people helping someone is to do a bit of babysitting, lend them a few bob or give them a lift to the supermarket. For Pam it was a potentially life-threatening operation and months of post-operative recovery.

But she knew more or less what she was letting herself in for and when she did not hear from Leyla's consultant for almost a year after her initial offer she was very disappointed. Finally, in June 2002, both Leyla and Pam were asked to go to Southmead Hospital in Bristol for tests. They proved a very good match.

"There are six main factors in a transplant and Leyla and I were a match in five, which is very good," said Pam. "We were delighted."

Dozens more tests followed and Pam was allocated her own consultant to look after her interests and explain all the risks.

"It was quite a long list but a lot of the risks were those that apply to any operation and I was assured that they would do everything in their power to prevent anything going wrong," said Pam.

She is honest enough to admit that at this stage she did begin to have second thoughts about going through with the operation.

"It did put me off a bit I have to admit but when I didn't hear from him for three to four months I thought there must have been something wrong with the last test and I felt disappointment."

At her next appointment Pam saw a different consultant who went through all the risks with her again and explained what measures would be taken to prevent each one.

"I was a lot happier after I'd seen him," said Pam, "and went on to have the tests on the health of my kidneys."

Pam had originally been worried that at 55 she would be too old to donate a kidney but the tests proved hers were in perfect condition.

Had one been in slightly better condition than the other, Pam would have been left with the best one, which is standard practice with live donors.

The transplant

With all the tests finally over the date of the double operation was booked for Jan 6 this year and was initially a great success. Aunt and niece were put in the same ward so they could watch each other recovering.

"It was lovely, everything went really well and we both felt so well," said Pam, who was released from hospital a week later. Things did not go quite so smoothly for Leyla.

Although she left hospital as planned about a week after her aunt, when she went back for a blood test the following day it was discovered that her over-efficient immune system had again become a problem and despite anti-rejection drugs had started to attack the new kidney.

She was kept in hospital for over six weeks while the doctors tried various combinations of drugs to defeat the immune system.

On one particular day in hospital a fellow transplant patient with whom Leyla had become friendly died from complications with her third transplant and Leyla was told she had developed diabetes as a result of all the steroids with which she had been treated over the years. "That was a bad day," she said.

Since then, however, the rejection has been overcome and Leyla has been improving in leaps and bounds.

"I'm not quite back to normal yet," she said, "but it is so much better than on dialysis and even though I am now diabetic I can eat so much more than when I was on dialysis.

"My life is now full of choices and I have the freedom to lead a normal life, to work, go on holiday or weekends away, eat pretty much what I want, get a good job, buy my own house and have children. It is wonderful to have a normal future."

She finds it difficult to put into words her gratitude for the woman who has, literally, given her a new lease of life.

"I can't really express the difference it has made, not just physically but also emotionally. The fact that someone can be so selfless is just amazing. I have a fantastic auntie," she beamed.

Pam also feels good. Four months after the operation she says she still feels some discomfort but was warned it would be six months before she felt anything like normal.

"I feel absolutely fine. I can do anything, go for long walks, dance, jump about, anything," she said, adding that she had noticed no difference at all in the way her body functioned with only one kidney.

"One of the reasons is that my kidneys were so good and the other is that when one is taken away the other compensates, grows a bit and does the work of two."

Pam's decision to donate her kidney was supported by her whole family, her husband, children and her parents.

"They left the decision to me and said they would support me as much as they could, and they have. They have all been very good to me," she said. Pam's daughter, Karen, is full of admiration for her mother.

"I think she's wonderful for doing it," she said. "Obviously I was worried before the operation but now I am really pleased she has done it and I'm very proud of her."

Pam is in no doubt that she made the right decision. "It is a great feeling. Any pain and discomfort that I went through is all worthwhile in the end to see the success of Leyla looking so well and so happy."

For Leyla's mum Ros, who had to watch her daughter suffer for so many years, the fact that Pam came forward as a donor is unbelieveable. "It is such a miracle," she said. "I still can't believe that it's been possible."

*Leyla and Pam and Ros would like to express their thanks to the staff at Southmead Hospital for their wonderful treatment and they would like to encourage everyone to think about organ donation, not necessarily live donation but certainly after death.

And they stress that it is important not just to carry a donor card but also to register as an NHS organ donor and to tell people that they have done so (see panel).

Facts about organ donation

Over 5,000 people in the UK are waiting for an organ transplant that will either save or dramatically improve their lives.

Many people each year will die before they receive a transplant. As many people as possible are needed to be prepared to donate after their death to help reduce the waiting lists.

Statistics show that anyone is much more likely to need a transplant than to become a donor.

There is no truth in the rumour that doctors and nurses let people die because their organs are needed. Their entire training and commitment is based on doing everything possible to save life.

Organs are only removed for transplantation after a person has died. Death is certified by a doctor or doctors entirely independent of the transplant team.

The removal of organs is carried out with the same care and respect as any other operation.

The funeral need not be delayed. To register as an NHS organ donor pick up a form and donor card from any hospital or doctor's surgery or log on to www.nhsorgandonor.net

Having registered, make sure that those closest to you know what you want, should the need ever arise.