Hello Donorswife,
If it makes you feel any better, I am/was one of those reluctant and ambivalent donors. I donated to my brother in 2007. He was 36 at the time and I was 44. He suffers from Iga nephropathy, an auto immune disease that attacked his kidneys. My other brother had borderline labs and was not eligible to test and my sister was not the same blood type. We were a 6/6 match so I felt like I could not donate. He would never get as a good of a match as he has with me. That being said, family donors and siblings in particular have a unique relationship. We often bring a lot of baggage to the table. Sometimes it's not even about the kidney but lots of other things that have been under control all the years. When a crisis hits some of that baggage "gets unpacked".
Another issue about family donors is that we do share a genetic make up, family health history etc. That's what often makes us a good donor choice in terms of matching. So it is scary to give up half your nephrons when you also have a family history of the diabetes and high blood pressure which often put the recipient in kidney failure to begin with.
What I can suggest that was helpful for me was to meet with a social worker to have a safe place to vent and express myself. I knew I had to do this, but what I wanted was for my advocates to say, yest this is a hard thing to do, but we will help you through it . I wanted to stop hearing about how you only need one kidney to exist and how easy the surgery. This of course, was coming from people with two kidneys!
The transplant center is going to be looking out for the recipient and try to get as good a match as possible. I think providers and sometimes the recipients themselves, have a sense of entitlement to the family kidney. The assumption is that everyone would want to do this. The surgery is painted as minimally invasive, no cost to the donor, go home after two days, everyone only needs one kidney (even call it a spare). So you really need to have someone who will advocate for you both emotionally and medically.
The other suggestion, is given the borderline labs, I would have your husband see an independent nephrologist to review all the testing, the labs, maybe get a 24 hour blood pressure, and see if he would be a good candidate to donate given his family history. And if he is not, then there may be others, even non related who would make a better candidate both physically and emotionally.
There is a nice book out there called The Reluctant Donor by Suzanne Ruff. Talks about family donation in a very honest and real way.
Whatever the decision, I hope all goes well. Wishing you and your family all the best.
Sherri