When doctors gave Taupō mayor David Trewavas the ultimatum "if you want a future you need a kidney transplant", his wife quickly dismissed any debate on what they would do.

"Anna said straight away she'd give me a kidney, which is quite emotional really," David told the Herald on Sunday of the life-saving offer made in March last year - when the 56-year-old went on to dialysis.

"I said 'don't worry about it, you stay good to look after Ruby' [their teen daughter], but she said 'no no'."

Despite her own fears of the medical procedures involved, Anna remained matter-of-fact about the decision after their 10-hour joint operations at Auckland Hospital on January 7.

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"I wouldn't say the process of getting here has been easy but I never hesitated about offering at all. Because I've seen the end result in the dialysis clinics where David spends time," Anna said.

It was a procedure that began at 9am when Anna went under a general anaesthetic, and ended at 7.30pm that night as David awoke with three kidneys - but only one that worked.

"I was very nervous, quite emotional actually. Especially the night before we stayed in hospital," Anna said.

"The surgical staff were amazing, I was crying the whole time. I haven't had a lot of operations."

Now nursing "tender" post-op bodies and recuperating at a friend's beachfront apartment in Kohimarama, Auckland, the couple are reflecting on the past nine months.

The initial hurdle was that Anna did not have a blood type compatible with David's.

Therefore, if the operation was to proceed, it would have to be an ABO incompatible kidney transplant.

"They did six operations like ours last year, ABO incompatible. You have to go through all the tests, and at the end if they're happy, they'll do it," Anna said of the publicly-funded procedures, which cost about $500,000.

The couple have been told David's transplanted kidney has a 20 per cent fail rate long term, and requires him to take more than 30 tablets a day going forward.

Taupo Mayor David Trewavas and wife Anna recuperating in Kohimarama, Auckland, after their kidney transplant operations. Photo / Michael Craig
Taupo Mayor David Trewavas and wife Anna recuperating in Kohimarama, Auckland, after their kidney transplant operations. Photo / Michael Craig

There was a brief period last year when Anna thought she had been given a reprieve, after another compatible blood type organ donor emerged.

After publicising his battle with chronic renal failure among his Taupō constituents, a woman in Palmerston North offered David a kidney in mid-2018.

"The woman went through the whole process and she failed the last test which, interestingly, is for kidney function. She had 80 per cent - you've got to have 90 per cent," David said.

Anna said having to readjust to again being a donor put her through a "rollercoaster" of emotions.

"They picked me up again, which as you can imagine is quite interesting emotionally," she said. "It's a big thing to go through as a married couple."

The first serious symptoms of David's chronic renal failure appeared soon after his election as Taupō mayor following the 2016 local body elections.

"I just started not feeling that well. I could only have a beer and that was enough," he said.

"I had some blood tests and they found I was on about 20 per cent kidney function."

For the duration of David's two-year battle with chronic renal failure, he remained in fulltime work at Taupō District Council.

"Well my job is cups of tea and biscuits, of course, so it's not physical work," he said.

"I was lucky in my role. I have a really good deputy, she would go to things at the drop of a hat. I think I only missed one full council meeting in two years."

David can't yet say whether he will contest the next local body elections later this year - he will have to wait to see his prognosis.

Doctors have told David his new kidney could last anywhere from five to 30 years.

"We're not out of the woods yet, because they can fail after a month," David said. "The surgeon said you've got to treat it like a little baby."

But it is a lot better than his health prognosis without a transplant - an estimate of 10 years on increasingly diminished quality of life.

And whatever happens, the youngest of their four daughters, 13-year-old Ruby, summed it up for the family.

"I'm nervous, but pleased to get my old Dad back," Ruby said.