It's extremely rare when someone asking for nothing in return steps forward at a hospital and offers to donate a kidney to a complete stranger.

What's rarer still is what has happened at Loyola University Medical Center four people have stepped forward and offered to donate kidneys to four complete strangers and none have asked for a thing in return.

"This is completely unique and totally unheard of," said Garet Hill, founder of the nonprofit National Kidney Registry, which coordinated the donations. "We have never had four donors from one institution come forward at one time to offer up kidneys for donation with no strings attached."

The selfless acts by the four have helped Loyola launch its Pay-it-Forward Kidney Transplant Program, the first of its kind in the Midwest, and the largest number of altruistic donors to ever begin such a program in the United States.

"This represents a spectacular improvement in our nation's approach to living-donor kidney donation," said Loyola kidney transplant surgeon Dr. John Milner, who helped spearhead the initiative. "It's a huge opportunity to expand the pool of donors and dramatically reduce the times people spend waiting on transplant lists for a new kidney."

The donors are Christina Lamb, 45, of Melrose Park, Ill.; Cynthia Ruiz, 22, of La Grange, Ill.; Jodi Tamen, 45, of West Frankfort, Ill., and Tim Joos, 53, of St. Charles, Ill.

A Pay-it-Forward kidney transplant begins when an altruistic donor steps forward and offers to donate a kidney to a stranger, beginning a chain. The donor's kidney is then given to a compatible transplant candidate who has an incompatible donor who then agrees to give a kidney to a third person with an incompatible donor, and so on. Potentially, the chain can go on forever.

"It's just like in the movie 'Pay It Forward' when someone flips you the keys to a brand-new Jaguar and then walks away," Milner said.

Currently, more than 82,000 people are on the waiting list for a kidney transplant, according to the United Network for Organ Sharing (UNOS), which maintains the national waiting list. The average wait time is five to seven years. By utilizing a powerful complex computer algorithm, the Pay-it-Forward concept rapidly links up compatible donors and recipients from across the nation with the goal of cutting that wait time in half.

"On average, each altruistic donation has led to six transplants so potentially Loyola's four donors could result in 24 people receiving transplants very soon," Hill said.

Besides dramatically increasing the number of transplants that can take place, the Pay-it-Forward program represents a radical shift in how kidney transplants are performed.

"What traditionally happens is that a hospital will take an altruistic donor and keep that donor within its walls and get only one transplant done," Milner said. "We, however, view these donors as national treasures and not institutional commodities to not be shared. We will offer our donors to any other hospital with the goal of getting more people transplanted. "

A Pay-it-Forward kidney transplant can easily be confused with a paired donation in which a transplant candidate has a willing donor who is incompatible. In this instance, the pair is matched with a compatible pair in the same situation and they go on to swap kidneys.

However, a pair donation has a major limitation. The surgeries have to be performed simultaneously in the same hospital since a donor could decline to donate after their partner receives a kidney from the other pair.

"The advantage of a Pay-it-Forward transplant is that the surgeries don't have to take place simultaneously or in the same hospital," said Loyola transplant surgeon Dr. David Holt who also helped spearhead the Pay-it-Forward concept at Loyola. "One of our donor's kidneys is headed to a patient in Philadelphia and another to a patient in Los Angeles. Also, let's say a donor drops out. No biggie. We'll start another chain."

Including the patients in Los Angeles and Philadelphia, Loyola's Pay-it-Forward program has already demonstrated its remarkable potential. Less than two weeks ago, Robert Rylko of Rockford received a kidney from Lamb.

Also, the program may have come just in time for 19-year-old Melissa Clynes of Missouri. Melissa's kidneys were destroyed by medication she has taken since infancy when she had a heart transplant. Three years ago she received a kidney from her mother Mary, but a virus caused the transplant to fail. Since then, Melissa has had a difficult time finding a match until recently when Ruiz, 22 was found to be compatible with her. The transplant is schedule to take place on Monday, March 29, at Loyola. As part of the program, Melissa's sister, Sarah, will donate her kidney to a stranger in a few days.

"Two weeks ago I was just devastated. I had already sent out 11,000 flyers and set up a Web site but nobody matched up until I Googled, How to fine a live kidney donor and found the National Kidney Registry,'" Mary Clynes said.

For the first time, Robert Rylko and his family and the family of Melissa Clynes will meet the altruistic strangers who donated kidneys to Robert and Melissa. The meeting will take place at 10 a.m., Tuesday, March 30, at Loyola University Medical Center in Maywood, Ill.

Source: Loyola University Health System