An estimated 62,000 people in the United States have severe kidney failure. To lead a normal life, each needs a new kidney, preferably one transplanted from a healthy living donor. Some are lucky enough to have a family member or friend with a compatible blood type who is willing to donate.
But a few will receive a kidney from a complete stranger, an "altruistic donor," as they're called, who has decided to undergo surgery to save the life of someone he or she may never know.
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Daryl Julich, from the state of Iowa, is one of those rare people. He traveled more than 1,600 kilometers to give away a kidney at New York Presbyterian Hospital / Weill Cornell Medical Center.
Daryl and his wife, Sher Jasperse, have come to New York City from their home in Iowa so Julich can give one of his kidneys to a stranger. He's motivated, he says, by his Christian beliefs.
"For me when you give something, things come back to you tenfold," he said. "It's like giving birth to a child, but I'm not giving birth to life, I'm giving quality of life to someone. And that's pretty neat."
An Internet kidney registry matched Julich with a patient whose family members can't donate to her because their blood factors aren't compatible. Julich and his wife paid for their trip to New York and will lose several weeks' pay. They expect nothing in return, but hope that Julich's gift will begin a donation "chain" that will save many lives.
Sher Jasperse explains.
"Someone who needs a kidney, they may have a family who would like to give a kidney, but is not a match for them," she said. "So, that family member makes themselves available to give to another person who needs a kidney, and then someone from that family gives to another family, and often an altruistic donor can start that process. The hope is that there will be an endless donor chain of people giving to other people."
Officials at New York Presbyterian Hospital have told Julich only that the recipient is an otherwise healthy woman, 76 years old.
"And they said, 'How would you feel about that, would that deter you from giving?', and I said 'No, not at all'," Julich said. "We just put too much emphasis that when someone gets old they're not useful any more. That's not true."
New surgical techniques have made kidney transplants more successful, and less risky and painful for the donor. Julich's operation will require only a short incision in his belly button.
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Surgeon Joseph Del Pizzo inserts a tiny telescope into Daryl's abdomen, using images projected on overhead screens to guide his surgical tools.
Once the kidney's surrounding tissue is snipped away and the arteries sealed off, the operating room lights go back on. The surgeon pulls the kidney through the tiny incision, and carries it in a plastic jug to the operating room across the hall.
There the hospital's chief of transplant surgery, Sandip Kapur, takes over. The patient is already unconscious, her abdomen opened. Unlike Julich's donor operation, this surgery requires a large incision. The operation takes about three hours.
"She'd been waiting a long time, and she's very lucky," he said. "Because she was very highly sensitized, it was very difficult to get a good match for her, and then due to a stroke of luck, she had this wonderful altruistic donor who stepped forward."
For Daryl Julich, there are several days of pain ahead, but a sense of accomplishment.
"You know, whenever you give, you receive. I feel like I'm receiving quite a bit. It's just incredible, a gift that I can only do once," he added.
Julich and Jasperse met the recipient a week later, a day before their return to Iowa. They say the woman and her husband thanked them, and all four hugged.
A month later, the recipient's son underwent surgery at New York Presbyterian to donate one of his kidneys to a stranger, leading to more donations and, as Daryl Julich hoped, an unbroken chain.
