| Carnegie Mellon Today | Feature Stories | > Cover Story: Pay It Forward

By: Jennifer Bails

Barb Bunnell lies sedated in an operating room at Banner Good Samaritan Medical Center in Phoenix. The Arizona woman bears the same genetic burden as her mother and grandmother, who both died in their early 50s of an incurable disorder called polycystic kidney disease. Cysts have begun to grow and multiply on Bunnell’s kidneys, too, taking their deadly stranglehold on another generation. Eventually, the fluid-filled sacs will smother her kidneys entirely, plunging her into end-stage renal failure so that her body can no longer filter waste and toxins from her blood.

The 53-year-old grandmother already has lost more than 80 percent of her kidney function and suffers from back pain, hypertension, and anemia. Doctors are not far from recommending that she undergo regular blood-cleansing treatments known as dialysis, which involves spending several hours a day, a few times a week, hooked up to a life-sustaining machine that would perform the work of her malfunctioning kidneys until a deceased-donor organ comes along. Last year, almost 12 Americans died each day waiting for a kidney.

All too aware of the grim statistics, Bunnell had feared the worst. Until last summer, that is, when an algorithm—developed by Carnegie Mellon computer science professors Tuomas Sandholm and Avrim Blum and graduate student David Abraham—matched her with Matt Jones. Jones is a 28-year-old college student and father of four who works full-time at a rental car company to support his family. He wanted to donate one of his kidneys to a stranger, with no strings attached, simply because he could.

Many called him crazy; kidney removal is major surgery that kills three of every 10,000 donors. And what if his second kidney fails later in life? Or what if one of his children needs a kidney transplant one day, and he would have been an eligible donor? His fiancée and brother tried to talk him out of the operation. But Jones, who first learned about live kidney donation through a cable news program, was undeterred. “Around the holidays, do you ever put a couple of bucks in the red kettle for the Salvation Army?” he asks. “What I did is really no different. We only need one kidney to live. So if you’ve got something a little extra that you don’t need and someone else could use it to live a decent life, I believe you should share it.”

Doctors refer to Jones as an altruistic donor. Sandholm calls him an angel.

On a hot July morning, transplant surgeons make five keyhole incisions in the side of Jones’ belly. Next, the doctors inflate his abdomen with gas to separate the outer layers of muscle and fat from the pudding of organs within. Using a pencil-thin video camera to navigate inside the cavity, they start to dissect the tangled snarl of blood vessels attaching his healthy left kidney.

Bunnell waits for her gift in a nearby hospital bed. After living in fear for more than two decades, her transplant finally begins. And the miracle Jones touches off doesn’t stop here.

One week later, Bunnell’s husband opts to pay it forward by donating one of his own kidneys to another stranger, 32-year-old Angie Heckman of Toledo, Ohio. Ron Bunnell had intended to give a kidney to his wife, but differences in body chemistry prevented a good match. The algorithm pairs him with Heckman instead. “There were never any second thoughts on my part,” he says. “I was a little bit scared, but most people go through their whole life never receiving a gift as big as the one Barb did. So I really did want to donate a kidney in return no matter what the circumstances.”

The healthy kidney from Bunnell enables Heckman to begin her life anew, freed from the burden and risks of dialysis and effectively cured of an autoimmune disorder that caused her kidneys to break down. Now in turn, Heckman’s mother is slated to donate one of her kidneys in the coming weeks to keep another stranger healthy and alive.

And so on and so on, in theory, forever.

Experts say that organ donation chains like this one powered by Carnegie Mellon technology could help to solve America’s kidney shortage crisis and, in the process, save thousands of lives. There are nearly 75,000 patients in the United States on the waiting list for a deceased-donor kidney, according to the United Network for Organ Sharing (UNOS), which oversees the national database of clinical transplant information. Wait time often can stretch from months to years depending on age, blood type, and other variables.

People who wait long for a deceased-donor kidney may develop other serious medical problems, making them weaker going into surgery and more likely to suffer complications. Last year alone, approximately 4,000 kidney patients died because they did not receive a transplant in time.

Owing to the shortage of deceased donors, the best option for many people with kidney disease is to find a living donor—a healthy friend or loved one willing to donate a kidney so the patient can bypass the waitlist. On rare occasions, someone like Matt Jones is willing to give up a kidney to a stranger for nothing in return.

The medical benefits of finding a live donor kidney extend beyond the possibility of a shorter wait. The organs last nine years longer on average than from a deceased donor and usually require lower doses of potent anti-rejection drugs that make patients vulnerable to infection, high blood pressure, and other nasty side effects.

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“What a nice article. My brother is a heart transplant and through experience, we know it would have been easier to find his match this way. It's very nice to know we have people capable of writing the software to do the math, as well as people capable of giving in such an unselfish way.”
– Carol K. Lampe

“I just got a kidney transplant after waiting 7 years on dialysis. I got an email from a live donor but decided to wait for a cadaver one. This is based on reports I have read on kidneys deteriorating with age and that worried me. Also I am in contact with someone who donated to their niece only to be in 3rd stage renal failure 1 year later. I hope more research is being done into the long term of donor's health as much as research is being done on algorithims to matching donors to recipients. ”
– Angie

“The story is great. I just found out that I will have to undergo kidney dialysis because of my diabetes. Eventually I will go on a transplant list through the VA Hospital in Pittsburgh. I have 2 friends that have said whenever the time comes they will be willing to donate. Hope it will work. ”
– Ted

“This story really touches my heart. It is wonderful to hear that healthy individuals have compassion for those who are born with a disease that they have no control over. My son was born with a polycystic kidney disease and was diagnosed as a Type 1 diabetic at age four. The gratitude I have towards doctors and scientist is immeasurable. Stories like this help me rest knowing that when my son reaches kidney failure, there are people ready to help if I can not give him my kidney. I will be ready to pay it forward as well.”
– K. Hansen

“Mine is more of a question then a comment,I need to have my right kidney removed and do not have insurance.I have been trying to find some kind of program that would help with the costs.So far I have not been able to really find out anything so if someone can please turn me in the right direction I would great apreciate it very much. ”
– Jeanne Marie Mendoza


The harvesting of organs from deceased donors for cash is one thing. Volunteering one's own organs (kidneys) while one is ALIVE is another thing entirely.

I am a recent recipient of a kidney donated by a friend. I was at Stage V of kidney failure, perhaps months shy of requiring dialysis. I feel like the luckiest man alive.

My donor and I are interested in promoting the concept of live kidney donors receiving college tuition credits in return for their donations (along the lines of Obama's plans for national service--Peace Corps or military service--resulting in a 'free ride' through college). In order to qualify, the donor would have donate to whoever was the best match (not a friend or relative). In other words, it would be an anonymous donation, though donor and recipient could be put in touch with one another.

Consider that a kidney transplanted before a recipient needed dialysis would sidestep years of decreased productivity on the part of the recipient. Not to mention preventing years of physical PAIN, malaise, dietary restrictions, the cost of blood tests, blood pressure (and myriad other) medications, and, of course, the time, cost, and unpleasantness of dialysis itself!

Please visit our blog & join in the conversation (kidneytwin.wordpress.com).”
– Lea Jones