Christine Hargis had given up hope this spring that her mother would ever get the kidney transplant she needed.
Hargis, of Coello, Ill., and her mother were caught in the frustration and anguish shared by 80,081 other families on the national waiting list for a kidney.
"We'd been trying for almost two years. I match my mother and my antibodies were too high," Hargis said. "It kind of burst my bubble. I thought there was no hope, and then the doctors said, 'Well, there's this other program...'"
The program they were talking about was a chain of kidney swaps arranged by doctors at The Johns Hopkins Hospital in Baltimore after an altruistic donor in Baltimore decided to give a kidney to a stranger. The doctors decided to try to extend the gift by giving the donated kidney to a person who had a family member or friend willing to donate a kidney, and to give that kidney to another person who likewise had someone close to them willing to donate, and so on.
She signed up for the program, and just two weeks later Hargis got a call from her surgeon at Barnes-Jewish Hospital in St. Louis, who she said told her, "We're going to make medical history."
Hargis, 36, was the last donor in a 16-person, four-hospital, cross-country domino kidney swap that constituted the largest kidney donation chain on record.
It started with Thomas Koontz, the donor in Baltimore, whose kidney went to Mu Cha Leffler, a patient in the same situation as Hargis's mother. She needed a kidney and had a loved one who was willing to donate but who didn't make a good match.
A total of eight people in need at The Johns Hopkins Hospital, the Barnes-Jewish Hospital in St. Louis, INTEGRIS Baptist Medical Center in Oklahoma City and Henry Ford Hospital in Detroit received kidneys between June 15 and July 6.
Hargis's mother had the opportunity to speak with her kidney donor, 55-year-old Pamela Paulk, over the phone.
"It's surreal, it's like being in a 'Star Trek' program. Here I am standing and they took my kidney out two weeks ago," Paulk said.
Paulk had wanted to donate a kidney for years after watching the procedure at the Johns Hopkins Hospital where she works as the vice president of Human Resources. Then one day her friend Robert Imes, who also worked at Johns Hopkins as a painter, happened to mention he was in need of a kidney.
Paulk wasn't a match, so they were entered in Johns Hopkins' database of living donors willing to do kidney swaps.
"I have not stopped smiling," Paulk said. "I did great. I had no problems. It's just the most wonderful thing to happen to me to be able to do this."
Doctors involved with the transplant chain say the grand orchestration shows the lengths people will go to, to get past the current barriers of kidney donation.
"Donation is so important that we are willing to go to these lengths," said Dr. Lauren Malinzak, a Henry Ford Hospital transplant surgeon who completed a transplant from a kidney flown in from Baltimore.
"Waiting for a kidney is the biggest obstacle to transplants," she said.
Malinzak explained that even when a person in need has several willing donors with the same blood type, a variety of health problems can blow the donation.
"We do turn down a number of donors," Malinzak said. "The most common reasons why we turn down donors is for their own health because they're obese, or they have hypertension, or they have diabetes."