"She gave me her heart 50 years ago," says Austinite Mike Nipper of his wife, Peggy. "The least I could give her was my kidney."


On Nov. 12, Mike was able to do just that for his wife of now 51 years. He jokes: "I kept it in good shape for her."


Peggy was born with polycystic kidney disease, which means that cysts develop on her kidneys. It causes high blood pressure, and the kidneys affected eventually fail. Peggy’s mother also had the disease, as did her mother’s father and both of her brothers.


The disease has a 50% chance of being passed down. The Nippers are lucky: Their son and daughter have been tested, and neither has the disease.


Last year at this time, the couple learned that Peggy had stage 4 kidney disease, and that her kidneys were only functioning at 16%. The choice: go on dialysis or receive a transplant.


Peggy was afraid of a transplant. She remembers her mother getting a kidney transplant at age 69. The kidney came from a young man who died in a car accident in California. It never really took, the Nippers say, and Peggy’s mother died six weeks later.


Not wanting to relive that experience, she says, "I had decided it would just be dialysis."


Yet, she remembered what four years of dialysis, three times a week, was like for her mother. She would have a hard time traveling, needing to find a dialysis center in the area ahead of time.


Peggy’s doctors — including those affiliated with St. David’s North Austin Medical Center, where the transplant happened — explained that kidney transplants have really advanced, as have the anti-rejection medications.


The Nippers started attending information sessions and learned about paired kidney transplants. Mike could donate his kidney to someone who is compatible, and then it would either move Peggy up the transplant list, or, if they were lucky enough, the person he donated to would have someone in their life who could donate a kidney to Peggy.


He got tested to see if he was eligible to donate, if any of his six kidney markers matched hers and if they were blood-type compatible.


Three of the six markers matched, much like you would find with a parent-to-child relationship. They were blood-type compatible, too.


Even if Mike hadn’t been as good a match, he might have still have been able to donate a kidney to Peggy. Spousal donations, as well as other nonrelative donations, are becoming more common as anti-rejection drugs have improved, says Dr. Jackie Lappin, surgical director of the Kidney Transplant Center at St. David’s North Austin Medical Center. Lappin was the surgeon who performed Peggy’s transplant.


The first thing doctors ask when discussing a transplant is "Who is your donor?" Lappin says. Even if the markers or blood types don’t match, as long as they have someone who has two healthy kidneys and is willing to donate one of them, a way forward can be found, either through direct donation or by paired donation.


"Even unmatched has a good outcome," Lappin says.


A live donation is also better than one from a deceased donor, she says, because with a live donation you know the family history. You know the health of the kidney. You can schedule the procedure. The kidney has not gone through whatever trauma or disease caused the donor’s death.


Lappin estimates that if Peggy had not found a living donor, she would have been on the waiting list for six years. By that time, she might not have qualified as her disease progressed, even with dialysis.


"Waiting for the perfect kidney, you may wait and never get one," Lappin says.


The Nippers feel fortunate that his kidney was such a good match.


"I feel like God had provided from the very beginning for this solution," Mike says.


The Nippers, who are both 74, met in high school in San Antonio. While Mike went to the University of Texas to study engineering and participate in Naval ROTC, Peggy went to Baylor University to become a teacher.


She taught a year before they married, and then he went on to get his master’s degree.


"He says I saved his life because I talked him into getting his master’s," Peggy says, adding that the decision delayed flight school and kept Mike out of the Vietnam War. By the time Mike was fully trained to fly combat missions, the war had ended. He never flew in combat, never released a bomb from a plane, he says.


The Nippers built a life together, moving from Big Spring to North Carolina to Fort Worth before settling in Austin, where their daughter lives.


Once they knew Mike was a match for Peggy’s kidney, they decided to go on a riverboat cruise from Mississippi to New Orleans in October to celebrate their 50th wedding anniversary. Then, a few weeks later, they checked into St. David’s North Austin Medical Center and did the transplant. Mike stayed two days in the hospital, and Peggy stayed four days. Their neighbors brought food. Their kids took turns caring for their mom and dad.


The Nippers say the recovery was surprisingly easy.


As Mike’s kidney takes over, Peggy’s failing kidneys will begin to shrink. His kidney inside her will not become diseased with polycystic kidney disease. Mike’s remaining kidney inside his body will actually increase in size to take over the work of his missing kidney.


"It’s amazing," he says. "To me, it’s like science fiction."


One thing they have noticed: Peggy has energy again, and her blood pressure problem, which the kidneys were causing, has gone away. Her blood numbers are better than they’ve ever been, she says.


When someone donates a kidney, it’s like donating two, says Lappin, because it takes someone off the transplant list. She also estimates that if more spouses would donate, it would clear about 15 percent of the list.


The Nippers are not sure how they will celebrate this Valentine’s Day.


Last year for Peggy’s birthday, Mike bought her a new car. For their anniversary, they got the river cruise, and for Christmas, he gave her a kidney.


"I don’t know what she’s going to want this year," he says.


"I told him he didn’t have to get me any more presents for the rest of my life," she says.


And on this gift, he says, "I gave her a lifetime guarantee."