This is Indra and she just donated a kidney to her husband. It is interesting that each of the three doctors I have spoken to (two nephrologists and a surgeon) have mentioned that ‘rich’ people (in Nepal) don’t want to donate kidneys. They prefer to buy them from someone, somewhere in India with all the risk that that might entail. It is only the poorer that have family members donate. There is obvious necessity there – they have no choice financially – but equally it is never an issue to find a donor within the family to make this very selfless contribution.
Having said that, in poorer families, it doesn’t rule out duty to family before self and pressure from the family hierarchy.
Anyway, a key point here is that you don’t have to be biologically related to the recipient to be a live donor. The other point is that donors can and do lead a fully normal life after donating a kidney.