There are 90,000 people in the United States waiting for a kidney and all it takes is one stranger to begin a chain of events that has the potential to save an ever-growing number of lives.
Rick Ruzzamenti was the first link in the longest such chain so far -- known in this case as chain No. 124, as The New York Times first reported, a stranger who began a domino effect of generosity spanning across the country.
Ruzzamenti gave his kidney to someone whose family couldn't provide a match and the family member who was not a match in this circumstance was a match for Brooke Kitzman from Michigan. And so it went, on and on, as strangers bound together through common circumstances gave and received kidneys as part of a chain started by a man who had no specific attachment to the cause.
There was the ex-boyfriend who saved his ex-girlfriend and the old prom dates from Queens, N.Y -- Gregory Person donated his kidney so Zenovia Duke could get a kidney from Samantha Hendon in Porterville, Calif.
The mastermind behind it all is Garet Hil, an ex-Marine with an MBA and his own company, who every day before dawn orchestrates the blood types, the profiles and the logistics of the most three dimensional kidney chain ever tried.
Hil says a singular event inspired him to start a kidney registry: When his then 10-year-old daughter needed a kidney they went through 15 different possible matches until she finally got what she needed.
"We went into all the exchange systems in the United States and never got a match," Hil told ABC News. "When I saw these systems, I thought there needed to be a better way ... and that's what drove us to create the National Kidney Registry."
Over the last four months, 17 hospitals and 11 states, Hil's mastery of the system has helped save one life after another until finally the chain ended, setting a record with the 30th transplant, Donald Terry, a 47-year-old government worker.
"I felt myself dying on dialysis when the doctors called me [to say] he had a kidney -- he was going to have a donated kidney," Terry said. "I actually burst down in tears, I didn't know what to say -- I didn't see myself living five more years."
Terry had no idea that the two people watching over him were an ex-Marine and a stranger who on an impulse decided to become a donor.
"The only thing I can say is we have two kidneys and if you believe in God, you could say well maybe God gave us an extra kidney so that we could give it away," Ruzzamenti said. "Just for a few, a month or two moments of some pain, you can really relieve the suffering of another individual. ... The amount of suffering and pain and discomfort or whatever that I went through is just absolutely nothing for the amount of good that came with it. You know, if I had another kidney, I would donate that one too, no problem."