Carolyn Hochkins knows only one thing about the person to whom she owes her life, and she learnt it from her physician.
Their kidney was a small one.
It was a good one too, because it succeeded where others had failed – first her own and then an earlier transplant – and is still keeping her alive 41 years later.
"We're one and the same now," she said.
But she never stopped thinking about the soul who was born with it, nor the inexplicable kindness of that person's family in giving it to a stranger.
"We're so grateful to the family who decided to do this. I have thanked them every day for the love and generosity they had for their fellow man."
Mrs Hochkins is the second-longest surviving kidney transplant recipient in NSW after receiving her kidney in 1974, nine years to the day after the nephrology unit opened at Prince Henry Hospital.
On Wednesday, the unit will celebrate its 50th birthday and the nearly 1400 transplants it has tallied, first at Prince Henry and later at Prince of Wales and the Sydney Children's Hospital.
Founding unit head David Jeremy remembers the gathering confidence of the medical team as they worked through the night to complete the first kidney transplant in NSW in 1965.
The patient, Dorothy Wilkie, had developed kidney disease from taking Bex powder and was being kept alive by dialysis.
The medical team had been practising on models, but the initial challenge was in sourcing a kidney for her.
"There were too many people who needed transplants and not enough kidneys available," Dr Jeremy said.
"The transplanted kidney worked quickly from the beginning and we were very pleased with that."
It lasted 32 years until her death.
Two years later, two more milestones were met with the first live kidney donation and the first pediatric transplant, when a man donated a kidney to his 13-year-old daughter.
But children under 10 were still not considered appropriate candidates for kidney transplants, and it was not until 1978 that a child under 10 was transplanted, an eight-year-old girl.
The then paediatric unit director Andrew Rosenberg said it had previously been considered too much of a drain on resources and unfair to the child when the outcome was certain.
"It was a very new procedure and everyone was sweating on it," Professor Rosenberg said.
"I can remember a lot of sleepless nights."
The five-year patient survival rate was 60 per cent in the 1960s. It is now 100 per cent for living donors and 97 per cent for deceased donors.
Head of nephrology Zoltan Endre said better immuno-suppressant drugs hadlowered the rejection rate.
There have also been changes in ethics, which used to dictate that a kidney could be removed only after circulatory death, whereas now kidneys can be taken from people who are brain dead but whose hearts are still beating - which means the organs are in better condition.
Although the donation rate is too low, it has been boosted by programs such as the Australian paired kidney exchange program, which pools all people who want to give a kidney to a loved one but are not a good tissue match.
The hospital has also improved the way that it relates to the family of the deceased.
"What we really need is for someone to sit with the family and talk them through it and that's happening more and more," Professor Endre said.
"They say goodbye and [the deceased] is taken down to theatre and their organs are taken out and they're taken off. That part is really hard for the donor family … and that's where I'm never sure that we can ever do enough for them. It's such a terrible 24 hours."
But many families took comfort in the idea of the organs going to a good home.
"I can regale you with countless stories of families who have been really pleased that something good has come out of the death of a loved one."
DonateLifeWeek runs from August 2-9. donatelife.gov.au
