Although she did not realise it at the time, Sharimah Mustafa’s three miscarriages during her first marriage and the difficulty she had conceiving during her second marriage were due to kidney problems.

It was only when the former nurse was diagnosed with pre-eclampsia during her last pregnancy in 2003 that it was discovered she had chronic glomerulonephritis, as well as high blood pressure.

Glomerulonephritis is the inflammation of the glomeruli, which perform the filtering function of the kidneys. Interestingly, high blood pressure can either be a cause or a result of this condition.

As the best way to treat pre-eclampsia – a potentially life-threatening condition – is to give birth, Sharimah had to deliver her second daughter, Siti Aishah Linnéa Nordvall, at 21 weeks of pregnancy.

Despite having to spend 45 days in the incubator, Aishah turned out fine.

However, Sharimah, now 50, was told that the condition of her kidneys were such that she had only about five years before she had to go on dialysis.

“But I managed to stay healthy for another six-and-a-half years,” she says, with the help of medication and regular follow-ups.

Then in 2009, while she was visiting her in-laws in Sweden, she got an infection and her kidneys overloaded, leading to an admission to the intensive care unit (ICU).

Her kidneys had finally given up and she had to start haemodialysis.

During her time on dialysis, Sharimah also explored the option of getting a kidney transplant.

Plans to go to Riyadh (she moved to Saudi Arabia to work in 1995, remarried there and still stays there) and China for the transplant fell through.

And while her husband was willing and found compatible to give her his kidney, he was diagnosed with diabetes just before the transplant, disqualifying him from donating his organs.

At the same time, one of Sharimah’s sisters, who had been on dialysis for 15 years since she was 25 and had been bedridden for the past two years, passed away.

The suffering and death of her aunt, as well as the death of her father the year before, prompted Sharimah’s first daughter, Siti Faridah Ahmad Zain, to insist that her mother take one of her kidneys.

The Kuala Lumpur-based homemaker shares: “I did mention to my mum before, ‘Why don’t I give you my kidney?’, but she just pretended like she didn’t hear me, so I thought that maybe she didn’t want my kidney.”

But later, her mother’s friend came and asked her if she was really serious about donating her kidney to her mother.

“She said my mum was afraid whether I really wanted to donate my kidney.

“I said, of course, she’s my mother! I already don’t have a father, if I lose my mother to kidney failure, I can’t imagine what life will be like,” says Faridah, adding that she was not afraid of the procedure.

However, there was a big snag: Faridah has blood type A, while her mother is blood type O.

Fortunately, consultant nephrologist Dr Wong Kai Cheng, who had taken care of her aunt in Penang, referred them to his fellow consultant nephrologist Datuk Dr Tan Si Yen in Kuala Lumpur.

Dr Tan had pioneered blood group incompatible, or ABOi, kidney transplants in Malaysia, performing the first such transplant in July 2011, the year before.

He agreed to take on Sharimah’s case, despite the fact that Faridah was obese with a body mass index (BMI) of 36.4 – a factor that would usually have ruled her out as a donor.

He explains: “Some transplant centres won’t do the operation if your body mass index is above 30, because the bigger the patient, the higher the risk of surgical complications, like wound healing.

“And technically, it is very challenging when someone is very obese, to get into the arteries.

“So, in Faridah’s case, it was very challenging, because she was one of the most obese we’ve operated on.”

In addition, Faridah was only 21 during the surgery and had not yet started a family.

“In the earlier days, we normally wouldn’t accept a donor unless they had already started a family, because we weren’t sure how well they would be (after the transplant),” he says.

While just one kidney is perfectly able to support the needs of a person, it was uncertain if only one kidney would be able to handle the additional physical stresses of pregnancy and supporting both mother and fetus.

“However, now that we know kidney donation is safe, we’re taking younger and younger donors who are allowed to get pregnant (afterwards) because we know that it is safe,” he says.

In fact, Faridah, who got married last year, gave birth to a healthy baby boy in February 2018, giving Sharimah her first grandchild.

Dr Tan notes that Faridah’s kidney function and blood pressure remain normal after her pregnancy, while Sharimah is also continuing to do well with her donated kidney.