Dear "Crowseye",
Hi. It looks like you have done your homework well. It certainly is a hard decision. I donated to a stranger 14 years ago at age 56 and am still doing fine now at age 70, even running half-marathons. My own recovery was unusually quick, and I was back to office work in one week, just needing naps and an early bed-time. But as you note, SOME donors do suffer complications or have a longer out-of-work recovery time, so it is a risk to be considered. I'll just add a few thoughts here:
--- Statistics in Europe (where they have done some long-term follow-up of living kidney donors, unlike the U.S.) indicate that those who donated to blood relatives have a slightly higher rate of later developing problems with their remaining kidney, as compared to those who donated to non-blood relatives (spouses, etc.) They suspect that there MIGHT be unknown genetic stuff which might pre-dispose to kidney disease, and that would be shared by blood-relatives to some extent.
--- Some kidneys from living donors last 20 years or more, but others fail earlier (or even in a short time despite the good screening). So many kidney transplant recipients may need a second (or third) transplant some years down the road. So if you donate now, at your age, his wife will still be available to donate, if needed, 10 or 20 years from now.
--- In the U.S., and I suspect also in Canada, it is illegal to receive payment for a donated organ. But it IS legal to receive reimbursement for all financial losses due to organ donation (lost wages, travel costs, out-of-pocket medical stuff, etc.) and to have fund-raisers for that purpose. Although it does involve some loss of privacy, your brother does have the option of organizing some fund-raising to cover your lost wages. Many people admire living donation and are happy to help out a living donor financially once they know the situation.
Well, that's all I can think of for now. Best wishes and prayers for you all as you work through this complicated situation.
Fr. Pat