Having stabilized her life, Lorraine learned from Ani that Ani was in need of another transplant and that her scheduled surgery with Joan had been postponed. Lorraine reacted without hesitation and volunteered one of her kidneys.
Arrangements were made for her to be tested in Arkansas. With the whole undertaking still on hold while medical issues were sorted out, it was impossible not to be struck by this new variation -- that now, two people were in this medical lottery, competing, in a way, to sacrifice an organ for a friend.
Those of us watching from the sidelines were astonished and impressed by the circle of women whose lives were suddenly interrelated and uplifted in ways no one could have anticipated.
Dr. Benvenisty was happy to have Lorraine tested as a backup but he also had his own plan.
Ani was within weeks of having to go on dialysis. Her creatinine was rising. She was exhausted. With time running short, Dr. Benvenisty turned to a process he uses on only about 5 percent of his kidney transplant patients. He put Ani through plasmapheresis, a process that temporarily removed antibodies from her blood to prevent them from attacking the transplant.
Then, another cross-match was done, with results that Dr. Benvenisty had hoped for. He felt that it was safe to go ahead with surgery and the logical choice, he said, was Joan.
"We already knew that Joan was a good donor," he said. "We had a CT scan and we knew the anatomy. We knew everything about her. ... We didn't want to take a chance that we would have a problem with Ani's health before we got her transplanted."
Lorraine flew to New York to offer her support and to join Ani and Joan on the day the transplant was scheduled: June 30, 2008.
Erik and Wil, the husbands, seemed to be the most nervous members of the group that gathered, which included Ani's parents.
Joan and Lorraine had their own, private meeting before the surgery. After the two hugged each other, Joan was the first to express what was on both of their minds, referring to the loved ones they had lost and the satisfaction that came from helping assure the future of Ani and her daughter: "What Ani has given both of us may be some closure."
"It has helped me as well," Lorraine said.
She had the feeling that her husband, Jonathan, was, in a way, playing a role in the event.
"I feel as if it's gone full circle," she told me later. "Now there's life given back to Ani. So it's an incredible opportunity for me to be here, and it's a huge, huge comfort."
Shortly after 8 a.m., Joan was wheeled into surgery. In an operating room lit by the glow of long tubes illuminated by a fiber optic halogen light source for miniature cameras, surgeons prepared to remove Joan's left kidney laparoscopically, with minimal invasiveness.
At 11:16 a.m., the kidney was taken from Joan's body and passed to Dr. Benvenisty, who had begun to prepare Ani in an adjacent operating room.
Including the preparation, Ani's surgery lasted 4½ hours.
"The kidney's in," Dr. Benvenisty finally said. "It looks real good."
The defining moment was when he first saw urine pass from Ani through the kidney that had been transplanted from Joan.
"Now it's Ani's," he announced in the operating room. "She has laid claim to the kidney."
Later, he added, "I find it miraculous every time I see it."