Wednesday, March 24, 2010

Kidney Donors Face No Shortening of Life

From the Wall Street Journal:

New Finding for Organ Donors


A major study of kidney donations provides the strongest evidence yet that organ donors live just as long as people who go through life with two kidneys.

Medical specialists say they plan to tout the findings in transplant literature to encourage more people to become living donors. Of the roughly 13,600 kidney transplants performed in the U.S. last year, 6,387 were from living donors, with the balance coming from deceased donors. A living kidney donation extends a recipient's life span by 17 years on average, compared with nine to 11 years when a kidney from a deceased donor is used. More than 84,000 U.S. patients are currently waiting for a kidney transplant.

The study, published this month in the Journal of the American Medical Association, "reconfirms what many of us have suspected, that living donation is a safe process for donors," says Matthew Cooper, director of kidney transplantation at the University of Maryland Medical Center, who wasn't involved in the study.

The study also seems to affirm the resilience of a healthy kidney, whose functions include filtering metabolic waste and regulating blood pressure. When people have two, normally functioning kidneys, neither works at full capacity, past research has shown. After one of the organs is removed, the remaining kidney picks up the slack—it grows 20% to 25% larger and becomes 20% to 30% more efficient over the next six months. "That seems to be more than sufficient in the vast majority of donors," says Bryan Becker, president of the National Kidney Foundation and a nephrologist at the University of Wisconsin.

The research, conducted at Johns Hopkins University, looked at all 80,347 living kidney donations in the U.S. between 1994 and 2009. Its findings generally support earlier studies involving relatively small numbers of kidney donors at individual transplant centers.

Among the latest findings, in the 90 days after surgery, 3.1 of every 10,000 donors died, a mortality rate about eight times higher than non-donors experienced, but still quite low compared to similar procedures. Over the longer term, however, donors died no more often than the control group, based on death data obtained from the Social Security Administration.

Though the researchers didn't measure donors' quality of life, smaller studies have found that kidney donation doesn't increase the risk of diabetes, stroke, cancer or heart disease. In fact, donors appear to have lower cholesterol and blood pressure.

For every successful transplant, scores of potential living donors begin the process. Most are immediate family of the recipient. But transplant centers are increasingly accepting non-blood-related donors, such as spouses, close friends and so-called altruistic donors, who offer to donate a kidney with no particular recipient in mind.

Candidates are screened for diabetes, high blood pressure, a history of kidney infections and other factors that would make life perilous with one kidney. An independent counselor ensures that the candidate is psychologically stable and hasn't been coerced into donation. At any point during the process, the candidate can withdraw.

There are a number of reasons that potential kidney donors may choose not to go through with the procedure, ranging from concerns about their own well being to financial considerations. Although donors incur no out-of-pocket medical expenses, transplant centers don't cover peripheral costs like travel or lost wages. Some candidates fear they'll face higher insurance premiums if the screening process reveals a health condition, or the surgery creates one.

Perhaps 10% to 20% of candidate donors withdraw for non-medical reasons, estimates Raymond Heilman, a Mayo Clinic nephrologist. The true rate is difficult to determine, as transplant centers closely guard potential donors' privacy. Many transplant centers offer a "medical out," citing a nonexistent condition like high blood pressure, to shield dropouts from familial pressure to donate.

Last year, living kidney donations saw their first annual increase in five years, to 6,387 from 5,968 a year earlier, after peaking in 2004 at 6,647. In efforts to make donating a kidney safer, nephrologists are increasingly adopting new procedures such as laparoscopy, an alternative to open kidney surgery. They also are seeking to do more with the existing pool of potential donors. Transplant centers are compiling a national database to help arrange complex swaps between multiple donors and recipients, aimed at finding biological matches more quickly for patients on the waiting list.

Monday, July 13, 2009

Ask The Kidney Donor

I’ve been answering a lot of email questions lately from prospective kidney donors trying to decide whether to go forward with the procedure. The same questions always seem to crop up. Here they are:


-- I’m thinking of donating a kidney and my friends and family are freaking out! What should I tell them?

I'm happy to answer any questions, but I don't want you to think I'm talking you into donating. It is a very personal issue, and you should make it based upon the facts of your life.

My friend Virginia Postrel wrote a great article called:

"Here's Looking at You, Kidney: How and why I became an organ donor -- and how I kept people from talking me out of it."

Her article started me thinking about donating, and her patience with my many dumb questions helped me during my own discernment process.

Most family members' objections boil down to:

1. Fear of the surgery
2. Fear of living with one kidney

Remind your friends and family of the following things:

The donation of a kidney is laparoscopic surgery, meaning small incision and quicker recovery. Most donors are out of the hospital on the next day, back at work in two weeks, and back to normal in a month. The surgery is no more dangerous than any procedure done under general anesthesia. The anesthesia is the real risk factor. Check out your doctor and transplant center. Get comfortable with both. Ask a lot of questions.

There is no scientific evidence in 50 years of living kidney donations that there are any ill effects to living with one kidney. Within five weeks of donation, the remaining kidney swells in size and increases its filtering power (the "glomerular filtration rate") to match the power of two kidneys. In short, you'll have a single super-kidney instead of two simply adequate kidneys.

When kidney disease occurs, it nearly always strikes both kidneys at the same time. It's not like one kidney fails and you find yourself knocking on wood, thankful that you've got a spare. If I should develop kidney disease, I will need treatment or a transplant – just like I'd need if I had two kidneys. If a kidney donor needs a transplant, they go straight to the front of the line on the kidney transplant list, which seems like a very fair deal to me.


--- What about saving your kidney in case one of your kids needs it someday?

This is the best argument I've heard against donating. That said, I couldn't justify not saving a life today because it might inhibit my ability to possibly save one in the future. My wife has a spare kidney for them, and we both have loving families who may be willing to help if one of my kids is in need of a kidney. Moreover, neither my family nor my wife's has any history of kidney disease, obesity, or diabetes.


--- What if something happens to your remaining kidney and you end up needing your second one?

Again, my family has no history of kidney disease. When kidney disease occurs, it nearly always strikes both kidneys at the same time. It's not like one kidney fails and you find yourself knocking on wood, thankful that you've got a spare. If I should develop kidney disease, I will need treatment or a transplant – just like I'd need if I had two kidneys. If a kidney donor needs a transplant, they go straight to the front of the line on the kidney transplant list, which seems like a very fair deal to me.


-- What if the transplant fails? It will have been a waste!

It happens. Then you will probably feel a real sadness but no regret about your ultimate decision. All you can do is all you can do. The rest is up to the doctors, God, and your recipient's body. Blood donors don't expect accountability and ultimate success regarding the ultimate success of their donations. Kidney donors shouldn't expect it either.


-- Have you had any residual pain or a feeling as if something is "missing?"

Nope, not even a little. In fact, if this were a science-fiction thriller where I was "missing" the memory of the 6 months following surgery, I would not have known it happened at all. Except for some small scars on my abdomen (see below).

The recovery process works in stages where there is some abdominal swelling (only you and your pants will notice) and the incision points will be tender for maybe six weeks after the surgery, but nothing permanent.

I found myself rather sleepy at night for six months following the surgery (like 9:30 p.m., rather than 11:00 p.m.). I think I was still healing internally. I think that evolved into a habit where I now go to bed earlier than I once did. I don't think this is kidney-related as much as I just became accustomed to being well-rested and getting an appropriate amount of sleep. I only mention it because I have spoken to many others who found themselves rather sleepy at night long after the pain of the surgery had gone away.


-- Have you had to make any significant changes in your diet and/or exercise routines?

Not really. No more knife fighting for me. I used to be an amateur boxer, but I gave that up long before my surgery. Had I continued boxing through the time of my surgery, it would have been wise for me to stop since repeated blunt trauma to the one remaining kidney could evolve into a melancholy situation.

There are some drugs synthesized in the kidneys, such as ibuprofen, that you may want to avoid as to not over-task your remaining kidney. Tylenol is fine. I still take ibuprofen once in a while because it works better.

I've been a strict vegetarian for nearly 20 years. In theory, I guess it would be unwise for me to start gorging on buttsteaks, become obese, and contract Type 2 Diabetes. But that would be a dumb idea anyway... A kidney donation should not affect your diet.


-- Will I have to give up drinking alcohol?

There are a million reasons to quit drinking, but a kidney donation is not one of them. Feel free to drink all you please. The liver takes the beating from your boozing, not the kidney.

-- How have your scars healed?

There are three scars. The two right beneath my left ribcage look like healed bullet holes which accentuates my gangsta image. The three inch scar along the elastic-line of my boxer shorts is generally hidden from the public. None of them are particularly unsightly. They are pinker than my skin, but I did absolutely nothing to treat them or care for them. Now that I live in Hawaii, they're probably getting too much sun.

This may call for some airbrushing when you appear in a 2010 swimsuit calendar, but I'm certain you won't be alone.

-- Have you seen any changes in your overall health?

None whatsoever. My blood-work continues to be far within the normal range, and I feel like a million bucks. Again, I want to stress, there is absolutely no difference in my health or my life before and after (pending recovery) the procedure.

-- What have you learned?

From a public policy perspective, I think “altruistic” donors should consider starting a kidney chain where they could save a dozen lives with their kidney, rather than just one. Here’s a great article describing how it works:

These were less common a few years ago when I set out to give away a kidney, and I’m overjoyed to have helped my recipient, Brenda. But for people who have no recipient in mind, kidney chain donations clearly do the most good for the most people.

Wednesday, November 19, 2008


I was just notified that my employer is relocating me to Hawaii for three years. My family and I will be moving to the island of Oahu at the beginning of March 2009. As soon as I become settled, I'll make myself available for kidney-related speeches at schools and professional groups in Hawaii in the same manner that I accept speaking engagements in Chicago. I shall return to Chicago in 2012. Aloha.

Saturday, August 16, 2008

Unsung Heroes Article from Washington Times

The FBI is celebrating its 100th anniversary this summer, and The Washington Times printed a long article detailing some of the fantastic work done by my collegues. They also included my kidney story which sticks out like a turd in the punchbowl in comparison to the other stories in the article.

It's a nice piece, but I'm far from "unsung".

The complete article can be found at:

Here's my section:

'Extraordinary' work of unsung heroes

by Jerry Seper and Jennifer Haberkorn, THE WASHINGTON TIMES
Friday, July 25, 2008

FBI special agents, working under the motto of "Fidelity, Bravery, Integrity," often are called on to do heroic deeds quietly and with little or no fanfare.

These unsung heroes routinely put themselves in harm's way, making split-second decisions to save lives or complete missions.

Many of the heroic efforts of the bureau's more than 12,500 agents go unnoticed...

Hot-line volunteer

Chicago-based FBI Special Agent Tom Simon doesn't think of himself as a hero. Married, the father of two young children and a crisis hot-line volunteer, he just wanted to do something for someone, so he donated his kidney to a young woman he had never met.

It was, he figured, a perfect match: Brenda Lagrimas was young, looking to start a family and in law enforcement. He got her name from donor Web site and figured it would be a good way to show others that donating a kidney was not that difficult or dangerous.

An FBI agent for a dozen years, Mr. Simon - who investigates major financial and white-collar crimes - underwent laparoscopic surgery in April 2007 at Northwestern Memorial Hospital in Chicago and within a couple of weeks was back on the job.

Six months after the surgery, Mr. Simon wrote to the Kidney Chronicles Web site, saying: "I donated a kidney to a woman named Brenda Lagrimas whom I had never met before embarking on my quest to donate a kidney to a stranger.

"Because of my job as an FBI Special Agent and the odd way that Brenda and I met, we ended up getting a lot of international publicity which led to an increased awareness of living organ donations which, in turn, led others to step forward and donate to strangers.

"Living with one kidney is no different at all from living with two. I'm not lopsided or fatigued or in pain," he said. "Brenda's recovery was slower, which is totally normal. From the moment of the transplant, her new kidney worked perfectly and her kidney-related health problems disappeared. We speak regularly and our families have all met. She went from being a stranger to an organ recipient to a great friend and for that, I am thankful."

Friday, July 25, 2008

More Glamour

The editorial in the August 2008 issue of Glamour Magazine mentions three women who were inspired by articles in Glamour. One of the women is Kathie Rabasco who donated a kidney after reading an article about me in Glamour. Best wishes to Kathie and her recipient.

Monday, January 7, 2008

Glamour Magazine

The February 2008 issue of Glamour magazine hits the stands across America on January 8. Among the perfume, skin care and herpes treatment ads is an article about my kidney donation to Brenda. It’s on Page 135 and the piece has a sizable photo of us taken the day before the transplant surgery. An excellent journalist named Sarah Robbins wrote the very dignified 200-word piece in a publication that, to put it kindly, doesn’t always reach very high to tackle serious issues in much depth (“Six Genius Love-Life Tips from Animal Trainers” anyone?). All kidding aside, Sarah Robbins wrote a solid article of which she should be proud, and my sources tell me that Glamour covers women’s health issues regularly with dignity and compassion.

As of the date I’m typing this, the article is not available online at Presumably there’s not enough bandwith available to fit my article alongside the piece about the couple who rebooted their relationship via a New Years Resolution to have sex every day. So, you’ll have to go to your newsstand or grocery store to purchase it yourself (“Plain brown wrapper, please.”)

My favorite line in the whole thing sums up the reason I do any press at all:

“I assumed it was this massive sacrifice, and you spend the rest of your life sick,” says the Chicago father of two. Then he learned that for donors, the procedure is relatively simple, with a quick recovery time - and that you can live just as well with one kidney as two.

As long as that point is driven home, my appearance in Glamour will be worth the mountain of crap I’m going to get at work for this particular piece of press exposure. (Why are FBI agents reading Glamour in the first place???)

My dad, for one, always wanted me to be in Sports Illustrated. He’ll just have to settle for this.


The article is now available online as a .pdf file at:

Wednesday, December 26, 2007

Wall Street Journal Article

Why It's Hard To Give Away A Kidney

Most Hospitals Avoid Donors Who Want to Help Strangers, Wary of Motives and Fearing That the Neediest Aren't Served


December 26, 2007; Page D1

Each year, hundreds of people decide they want to donate a kidney, not because someone they know needs a transplant, but because they want to help and don't care who benefits. But the desire to give can be hard to fulfill because many hospitals won't accept altruistic donors, and there are few resources to help donors navigate their options.

The hospitals' reluctance grows from concerns that these potential donors may be psychologically unstable, likely to change their minds and, perhaps, secretly paid for their kidneys. Given the risks of the surgery, which are small but real, some argue that it makes little sense for a stranger to donate a kidney.

"If someone really wants to help society, they can go work in a soup kitchen, they can join the Peace Corps, they can do a lot of things that don't put their lives at risk or implicate a [transplant] center," says Timothy Pruett, a kidney-transplant surgeon who is president of the United Network for Organ Sharing, which oversees transplantation under a government contract. His hospital, the University of Virginia, has handled just three of these donors, all in recent years.

Advocates of altruistic donation look at the UNOS transplant list -- where nearly 75,000 people are waiting for a kidney -- and argue that the nation needs every willing kidney it can get. Amid pressure to do more transplants, a few hospitals are starting to loosen their policies. A handful of online and other services have also sprung up that help match would-be donors with strangers in need.

But for the most part, such donors find that few hospitals are willing to take them. Garet Hill, a consultant from West Islip, N.Y., decided to help recruit altruistic donors after his 11-year-old daughter received a kidney from her cousin. He has created a matching service called the National Kidney Registry to help potential donors find a hospital that will take their kidney. Up and running for only about two months, the registry has received about 200 inquiries, most of them from people who said they were interested in donating anonymously to anyone who needs it. Of those, about 10 people have sent back follow-up paperwork so that Mr. Hill's group can make inquiries with hospitals.

The group has found that while some hospitals "welcome us with open arms," many aren't interested. "We had one hang up last week," Mr. Hill says. "What we're finding is odds are most transplant centers will not welcome you as an altruistic donor."

Over the past decade, more than 450 people have become anonymous donors. (Other altruistic donors have sought a stranger out for purposes of donating a kidney, but those numbers aren't tracked.) Many more have begun the process, but have been ruled out on medical or psychological grounds, or changed their minds. It's a tiny sliver of total live organ donors -- out of 6,400 living kidney donors last year, just 68 were anonymous -- but they raise particularly complex questions for both donors and hospitals alike.

The first question for would-be donors is who should receive the organ. They have two options: approach a hospital and offer their kidney to any needy patient, or hunt a worthy recipient on their own -- typically online. Both make transplant surgeons uncomfortable.

Ducking the Waiting List

For one, the waiting-list system is set up to allocate organs fairly, basically targeting the neediest and best-matched patient first. But allowing people to find donors online gives an advantage to the savviest recipients -- those best able to craft a heart-stirring online plea, and in some cases, those able to pay a Web site's fee.

One Web site,, charges needy patients $295 to post their appeals for 30 days or $595 for a lifetime posting. Would-be donors can peruse the profiles and pick who they like best. "Help for a pastor's wife!" headlines one recent posting. "Learning disabled woman needs miracle kidney," says another.

A survey published this year in the American Journal of Transplantation found that just 30% of transplant programs would consider a donor who was solicited through a Web site or other media outlet. "I can't stop people from making connections over the Internet," says Gabriel Danovitch, medical director of the kidney-transplant program at the University of California-Los Angeles. But he won't consider them at his hospital, fearing that online matching services "end up distorting the system."

Still, this approach appealed to Tom Simon, a 37-year-old Federal Bureau of Investigation agent in Chicago, who decided to donate a kidney after reading about living donations. He considered giving anonymously but had misgivings. "What if my kidney wound up inside a real jerk?" he says. He decided he wanted his kidney to go to someone young who lived a healthy lifestyle.

Mr. Simon went to and read the post for Brenda Lagrimas, who worked as an advocate for domestic-violence victims in Chicago. "My wife and I discussed the morality of 'playing God' and deciding who lives and who dies," he later wrote on a blog chronicling the experience. "Finally, I decided to go with Brenda for the following reason: if I had let the hospital pick my recipient, I would've hoped that the recipient's personal story be just like Brenda's story."

Hospitals' Rejection

Mr. Simon and Ms. Lagrimas had no problem finding a hospital in Chicago for the transplant, which was done last April.
Not so for Gabriela Lacabe, a 35-year-old preschool teacher who lives outside of Los Angeles. Ms. Lacabe, sick with kidney disease since she was 9, went online and found a 23-year-old nursing student from Alaska willing to give her a kidney. But her transplant center, UCLA, wouldn't consider the transplant. They tried St. Vincent Medical Center, but when St. Vincent learned that UCLA had rejected the donor, it did the same, according to David Lacabe, Gabriela's father. (St. Vincent couldn't be reached for comment.) Finally, the donor was approved by Cedars-Sinai Medical Center in Los Angeles, and the transplant was done in June.

One way around the ethical dilemma is to give anonymously to someone on the UNOS waiting list, an approach that appealed to Jim Falsey, now 62, a Catholic priest in Au Gres, Mich. He couldn't have imagined choosing the recipient himself. "How would you decide you're going to give to John and not to Mary?" he says.

He became interested in donating after his brother, Tom Falsey, donated one of his kidneys to a stranger. In fact, five members of Tom Falsey's extended family have donated kidneys: Two gave to Mr. Falsey's nephew (who needed a second transplant after the first replacement kidney failed), and three gave to strangers after learning about the nephew's struggle.

Jim Falsey says the decision was sealed for him during the Christmas season, when he read John the Baptist's admonishment that a man with two coats should give one to someone with none. The analogy to kidneys seemed obvious to him.

But donating to a stranger wasn't simple. Mr. Falsey's first-choice hospital, the University of Michigan, "hemmed and hawed" and appeared uncomfortable with the situation, he says. He did some initial testing, but they kept telling him to call back, and when he did, he says, they would put him off again. Frustrated, he tried another hospital where the donation was successfully done in 2004.

Krista Hopson, a spokeswoman for the University of Michigan, says the hospital has no policy automatically excluding anonymous donors, but she had no information on Mr. Falsey's case.

Of 166 hospitals that have performed kidney transplants, nearly one-third have never used an anonymous donor, and about half have done so three times or fewer, according to UNOS data. The survey in the American Journal of Transplantation found that about 40% of transplant centers will not accept stranger donations.

One of the concerns that transplant surgeons and others have about altruistic donors is that such people may be psychologically unstable and unrealistically hopeful that donating a kidney will change their lives for the better. There is near-universal agreement that these potential donors need particularly careful screening to make sure they are both physically and mentally healthy.

At UCLA, the program doesn't have enough staff to thoroughly screen potential anonymous donors, knowing that few will ultimately become donors, says Dr. Danovitch. Research at the University of Minnesota, the national leader in anonymous donors, found that of 360 inquiries between 1997 and 2003, just 42 went through the mandatory in-depth medical and psychological evaluation and only 22 transplants resulted.

There are no national rules governing who receives altruistically donated kidneys. Most hospitals that accept such donors say they simply give the kidney to the first person on the waiting list at their own center, without looking to see if there is someone who is a better match or has been waiting longer at a neighboring hospital. The United Network for Organ Sharing, which sets rules for the distribution of deceased-donor kidneys, has talked about setting rules for distribution of anonymously donated living-donor kidneys but has yet to do so.

'The Almighty Dollar'

At hospitals that are starting to allow altruistic donors, part of the incentive is financial, says Russell Wiesner of the Mayo Clinic Transplant Center in Rochester, Minn., which he says has lowered its standards and now takes a variety of donors who might have been nixed before, including altruistic donors. "The almighty dollar speaks loudly," says Dr. Wiesner, a professor of medicine. "Rewards and salaries are linked to how many [transplants] you do and how much money you make for the clinic."

There's also emotional pressure to approve donors. For years, Beth Israel Deaconess Medical Center in Boston wouldn't consider any altruistic donors, says Douglas Hanto, chief of transplantation. Then a longtime patient "ran out of other options" and decided to look for a donor online, and the hospital decided they didn't want to force him to go elsewhere.

The man wound up finding a cousin to donate, but the policy was changed, and Beth Israel will now consider altruistic donors. The hospital has yet to knowingly use an altruistic donor, Dr. Hanto says, though he found out after the fact that two patients had met their recipients online and lied about it.

Dr. Hanto still thinks there are good reasons to screen out these donors. But, he says, some of our patients felt "our position...was just a little bit too dogmatic, and a little too arbitrary."

Tuesday, December 25, 2007

Wall Street Journal

I received word that I will be in a kidney article in The Wall Street Journal written by the great Laura Meckler on Wednesday December 26, 2007. Check it out.

Wednesday, October 3, 2007


A Re-introduction:

On April 19, 2007 I donated a kidney to a woman named Brenda Lagrimas whom I had never met before the embarking on my quest to donate a kidney to a stranger. The details surrounding the surgery and the story of what brought Brenda and I together are detailed in the early entries of this blog -- down at the bottom of the page (April and May 2007, mostly).

Because of my job as an FBI Special Agent and the odd way that Brenda and I met (via the website, we ended up getting a lot of international publicity which led to an increased awareness of living organ donations which, in turn, led to others to step forward and donate to strangers.

If you have any questions, feel free to contact me at simonhere (at) mail (dot com). Here's a video to get you up to speed:

Health Update:

Nearly six months after the surgery, all is well with my health. Living with one kidney is no different at all from living with two. I'm not lopsided or fatigued or in pain. I don't pee more or less than I did before. I still work out a ton including some physical contact sports. Brenda's recovery was slower, which is totally normal. From the moment of the transplant, her new kidney worked perfectly and her kidney-related health problems disappeared. However, it took Brenda a while to find the "sweet spot" regarding the dosage of her anti-rejection drugs. Too much weakens her immune system. Too little increases her risk of rejecting my old kidney which would lead to her having to listen to me bitch and moan more than anyone should have to.

Anyway, Brenda has found the proper dosage of anti-rejection drugs, and she is now doing fine. We speak regularly, and our families have all met. She went from being a stranger to a organ recipient to a great friend over the course of this year, and for that, I am thankful.

Saturday, July 28, 2007

American Spectator: Whassup With That???

Some chooch named Lawrence Henry wrote a psychotic attack piece on me in The American Spectator. I replied in an opposing piece. Both are copied below.

First, Mr. Henry:

An Update on Transplant
By Lawrence Henry
Published 7/27/2007 12:08:35 AM

In an op-ed published July 16 in the Chicago Tribune, "Using the Internet to Donate Organs," Tom Simon argued the case for donating a kidney to a stranger via the website

"When I made the choice to donate a kidney to a stranger, I began the process as a non-directed donor -- meaning I was prepared to let Northwestern Memorial Hospital choose my recipient for me. I immediately began to have misgivings about this approach.

"What if my kidney wound up inside a registered sex offender or a violent ex-convict....I was less interested in saving the sickest person I could find and more interested in saving the life of someone who could make a difference in the world once his or her health was restored to normal.

"...I found the posting of a Chicago woman named Brenda for whom I felt a great deal of empathy. She was young, aspired to have kids and worked as a domestic violence court victim advocate for the Cook County state's attorney's office."

TRANSLATION: I WANTED TO DONATE A KIDNEY TO A LIBERAL. Does this kind of sanctimony make you as nauseated as it makes me? I have been on the other side of this Internet tease. I did a one-week trial with I wrote to four people of my blood type who stated on the site that they were willing to donate to anyone. The site's internal messaging system confirmed that my messages had been read.

I heard from no one.

I don't know what charges for the privilege of "playing God," as Mr. Simon so accurately puts it. But it costs about $700 for a "lifetime" membership for would-be recipients. I've been getting e-mail blandishments from the site ever since my trial membership. They have slick phone salespeople to try to persuade you to buy those "lifetime" memberships.

Here's the rub: If Mr. Simon and his like are "less interested in saving the sickest person I could find," that sickest person is left to die. Twenty percent of dialysis patients die every year. I've had one close call myself this year.

IN 1972, THE GOVERNMENT STRUCK A DEAL with private insurers. After three years of treatment, Medicare would take over insuring End Stage Renal Disease (ESRD) patients. That also qualifies most ESRD patients for Supplemental Security Income (SSI). Being in a weakened state, most of us take it.

As usual, the government had no idea what it was getting into. In its first full year of operation, the ESRD Medicare program was spending $229 million. By its tenth year, the program costs exceeded $2.5 billion. By 1997, that cost had ballooned to $15.64 billion. Most of this money goes toward maintaining dialysis patients. Transplant saves Medicare about 60 percent post-transplant, assuming a ten-year period, because, 36 months after getting a successful transplant, transplant recipients stop receiving Medicare payments. Transplant patients mostly return to normal lives (as I did for 20 years). Nearly two-thirds of dialysis patients, especially those with diabetes, find themselves unable to do any more than support their daily personal needs.

THIS IS A PUBLIC POLICY ISSUE, LIKE IT OR NOT. It makes sense for government to encourage transplant, as opposed to long-term dialysis, simply on the basis of cost outlay. But it also makes social sense, because transplant recipients lead transparently normal lives, working, paying taxes, raising families, contributing to the general welfare.

As always, faced with a system that doesn't work well, patients with the gumption have taken matters into their own hands -- and wallets. An old pal of mine, also going for his third kidney transplant, got in touch with me to urge me to solicit a kidney from my friends, church members, and associates. I did that, and ultimately found several willing donors. One survived the testing process, and was willing to donate to the swap program at my hospital. The database of potential paired transplant donations is being run now, and I should know within a couple of weeks whether or not I have a kidney.

The head doc of the transplant program here advised me to wait until the fall to see what the database turns up -- it changes regularly. If I don't have a kidney by that time, I will take a short trip to Tampa and register with a transplant center there. The waiting time for a cadaver transplant -- from accident victims, mostly -- is shorter in Florida than in the Northeast. I do not have to move to Tampa. I can simply be ready to hop a plane at a moment's notice. It's expensive, but lots cheaper than living the way I'm living now

PREFERABLY, TWO PROGRAMS OUGHT TO BE IMPLEMENTED. First, there ought to be a national program of reimbursal for "Good Samaritan" donors -- people willing to donate either to an individual or to a medical center's swap program. Put simply, you ought to be able to sell a kidney, or have yours heirs do so. Second, instead of asking people to designate themselves as organ donors through the driver's license programs of various states, it ought to flip over: People would be presumed donors unless they explicitly opt out.

This is called "presumed consent," and it exists in Portugal and Italy, where dialysis is minimal and transplant common. Unfortunately, an irreducible population of idiots in this country remains convinced that doctors wait, Frankenstein-like, scalpels at the ready, to turn an accident victim into a dugout canoe before he's really dead.

Ideally, both policies would work together. Presumed consent would tend to keep the otherwise-inflationary price for selling an organ down.

SO WHAT'S THE OBJECTION, IN THE MEANTIME, to Internet dating for organ donors? Several statistical realities.

Organ donations are matched up by blood type. As my doc told me, "The ABs cycle through very fast, because blood type is not an issue." An AB can receive a donation from anyone. Meantime, Bs, Os, and As wait, and are likely to be among the sickest cited by Tom Simon in his smarmy op-ed.

Internet matchups do little or nothing to even out regional inequities in waiting time. They do nothing much, at least intentionally, to alleviate the generalized, ill-distributed, suffering of the waiting population of transplant candidates. And they will tend to give kidneys, like Mr. Simon's, to those applicants who, naturally or by design, ring all the right Oprah-like bells to move Mr. Simon's and his cohort's questionable consciences.

Make no mistake, Good Samaritan donorship is in the wind these days. Transplant medical centers are filled with literature on the subject from the National Kidney Foundation, the very establishment of transplant.

It all helps. But it's still not enough.

Lawrence Henry writes every week from North Andover, Massachusetts.


Here is my response:

In Defense of Matching Donors

By Tom Simon

As an FBI Special Agent with 12 years of service, mostly in the Counterterrorism field, imagine my surprise to log onto the American Spectator website and read Lawrence Henry’s weekly column calling me a smarmy, sanctimonious liberal of questionable conscience because of my decision to donate a kidney to a fellow law enforcement professional I met via the website

In his piece, Mr. Henry recounts his own negative experience with that led him to the conclusion that donating a kidney via an internet-facilitated match is morally objectionable. I can’t help but wonder if his opinion would have been different had he achieved positive results after he spent his week begging strangers for a kidney on the web. Furthermore, I fail to see the moral distinction between Mr. Henry appealing publicly to strangers within his church congregation and my recipient, Brenda, making her appeal to a larger audience of strangers via the web.

The fact that Mr. Henry failed in his attempts to successfully procure a kidney via should be no surprise as he only gave it a week’s worth of effort. Brenda’s profile remained on the site for two years before I stepped up to help. Part of that may have been due to her having one of those hard-to-match blood types Mr. Henry cited in his piece.

The other factor is that living “stranger” kidney donations are very rare. Less than 100 individuals in America will step forward this year to donate kidneys to complete strangers. During the three year history of, the site has facilitated less than 50 kidney donations at a time where over 90,000 Americans await transplants. This tiny niche of the transplant field is hardly worth all this ethical hand-wringing when the number of lives being saved is relatively paltry.

I share Mr. Henry’s concerns with the expensive price tag associated with a lifetime membership to The site’s administrators (with whom I have no affiliation) informed me that they are a non-profit entity operating at a loss, yet they are committed to working with those in need by waiving fees or negotiating payment plans based upon the customer’s financial means. Personally, I think a better option would be for the United States to follow the lead of the Commonwealth of the Bahamas who recently inked a deal with to put 100% of the country’s organ transplant waiting list on the site.

Mr. Henry is also right in his public policy analysis regarding the need to compensate living organ donors and switch to a “presumed consent” system for cadaver donors. Curing diabetes would also be a big help. However, his vitriol toward internet organ matching and those of us who’ve volunteered to help is misguided and more than a little bizarre.

The best argument in favor of is Conservative to the core: it’s my kidney, and I’ll give it to whomever I damn well please. Would Mr. Henry police my charitable financial giving with the same zeal that he wishes living organ donations to be regulated?

Finally, I wish Mr. Henry best of luck with his forthcoming third kidney transplant. He indicated it will most likely be a paired or swap donation, another innovative solution to deadly kidney donor shortages. I only hope that the stranger whose kidney he receives is treated fairly and not subjected to name-calling in public forums.

Tom Simon is an FBI Special Agent in Chicago and a living kidney donor. His experiences as a living donor are recounted at He can be reached at simonhere at mail dot com.

Monday, July 16, 2007

Voice of the People

The Chicago Tribune printed a truncated version of my letter to the editor (see below). You can read their short version at:

Also, Brenda found an interesting article at:

Monday, July 9, 2007

Auditioning for a Kidney

The 7/9/2007 the Chicago Tribune printed an Op-Ed piece by Dr. Timothy Murphy, a professor at a local university where he beat up on Matching Donors. I submitted an Op-Ed piece in response to his article, but I have no idea if it will be published or not.

Here they both are, starting with Dr. Murphy's piece:,0,2650413.story?coll=chi-newsopinioncommentary-hed


Auditioning for a kidney

Transplant policy should be revised so organs go to those most in need, not those with the best appeal for help

By Timothy F. Murphy, professor of philosophy in the biomedical sciences at the University of Illinois College of Medicine at Chicago

July 9, 2007

Dutch television delivered a reality TV show like no other. Producers followed a dying woman as she chose which of three competitors would get one of her kidneys for transplant. The advance details were vague, if only because it was all a hoax: Nobody was dying, and everyone involved was an actor. By way of defense, the producers said they wanted to draw attention to organ shortages.

Finding organs for donation still is an uphill struggle in most countries. In the United States, people do not donate organs and tissues after death in numbers equal to the need. Surprisingly, living organ donors are not always so scarce. For example, since 2000, the number of living people who have given up a kidney for a family member or friend has exceeded the number of people who have been willing to donate kidneys after death.

This inclination to donate to a real, live person--instead of an unknown person on a waiting list somewhere--helps sustain an Internet site that matches living donors with people waiting for organs and tissues. At matchingdonors. com, people waiting for organs and tissues say a bit about themselves and what a transplant would mean to them. In fact, complete strangers do step forward to donate to people whose stories they find compelling. After these donors are screened, surgeons move organs from one body to another, relationships are forged and lives are saved.

Any transplant patient who receives an organ because a living stranger comes forward via the Internet wins the equivalent of a transplantation lottery. But people using the Internet to solicit donors represent only a tiny fraction of the nearly 100,000 people waiting for organs and tissues in this country. This kind of Internet publicity creates an express lane for some patients, to the disadvantage of others. Most people waiting for transplants are invisible to the public as they quietly wait for donations from the dead.

United States transplant policy must move to acknowledge the role the Internet has come to play in direct organ donation. Good-hearted people are using the Internet to search out people who need organs, but this approach does an end run around policies crafted to balance need and availability. To resolve this problem, the government could move to put people in need of a transplant on the Web, at least those willing to go public that way with a picture, a story, and some words of solicitation.

This way, strangers could search the entire catalog of people needing organs, with no one excluded. Yet this approach would ultimately pit transplant patients against one another, with advantages falling to the sympathetic and manipulative. Dubious motives--racism, sexism, ageism--could distort donation decisions as well.

In the name of protecting access for all, another option might be to bar the practice of stranger donation unless the donor surrenders the right to direct where the organs go. Some medical centers already accept stranger donations and treat organs obtained this way as donations from the deceased.

For example, a kidney donated by a stranger goes to the appropriate person at the top of the regional waiting list. This way, nobody jumps the line, and the accidents of fate--one's disease, one's skin color, one's age--don't stand in the way of hope for the organ one needs to stay alive. This option seems reasonable to me, but there may be other options out there that protect access and equity when it comes to sharing all-too-scarce organs. Let's get a discussion under way.

The Dutch public was cool to a television program that treated organ transplantation as reality-show fodder.

In the United States, we should learn from that lesson and reject the idea that one's media appeal ought to decide who gets a lifesaving organ and who does not.

Copyright © 2007, Chicago Tribune

Here is my response:

Internet Kidney Matches: A Donor's Perspective

by Tom Simon

On April 19, I donated a kidney to a woman I met via the website As such, I would like to add my perspective to the thoughts and ideas presented by Dr. Timothy Murphy in his July 9 commentary "Auditioning for a Kidney."

In his piece, Dr. Murphy makes the point that sites such as Matching Donors that allow potential organ recipients to present their cases to the public in hopes of finding a living donor are inherently unfair because they tend to reward the people with the best self-marketing skills rather than with the greatest medical need. He also makes the point that irrational biases such as race, gender, and age may unfairly factor into the donor's decision as to who will be rewarded with the life-saving gift of a vital organ.

When I made the choice to donate a kidney to a stranger, I began the process as a non-directed donor -- meaning I was prepared to let Northwestern Memorial Hospital choose my recipient for me. I immediately began to have misgivings about this approach. What if my kidney wound up inside a registered sex offender or a violent ex-convict? My personal biases were less demographically focused and more lifestyle-based. I was less interested in saving the sickest person I could find, and more interested in saving the life of someone who could make a difference in the world once their health was restored to normal.

I spent some time searching the Matching Donors site until I found the posting of a Chicago woman named Brenda for whom I felt a great deal of empathy. She was young, aspired to have kids, and worked as a domestic violence court victim advocate for the Cook County States Attorneys office. She was also experiencing severe kidney failure combined with complications arising from dialysis. My wife and I discussed the morality of "playing God" and deciding who lives and dies. Finally, I decided to donate my kidney to Brenda for the following reason: if I had let the hospital pick my recipient, I would've hoped that my recipient's personal story be just like Brenda's story. Given that reality, the final decision was easy.

The internet empowers the donor to make his own choice as to whom benefits from the gift of an organ donation. I also feel that as more people take advantage of the internet as a means to match donors and recipients, you will see less donors "chickening out" at the last minute. Being able to put a face and name with your intended recipient creates empathy and accountability – two major deterrents to backing out of this life-saving act moments before surgery.

I see nothing wrong with letting my emotions, preferences, and biases shape my decision regarding who gets my kidney. No one is troubled if I choose to give my other assets (i.e. cash) to people and causes I support. Why do people such as Dr. Murphy short-circuit when I decide to give my kidney to a person I support? Would he police my charitable financial giving with the same zeal that he wishes living organ donations to be regulated?

Dr. Murphy wisely suggested launching a website where all 100,000 needy potential organ recipients in America could put their stories on the web for the public to peruse. I suspect that would welcome the opportunity to serve this purpose. The good people at that website (with whom I have no affiliation) recently inked a deal to put 100% of the transplant waiting list of the Commonwealth of the Bahamas on their site. Dr. Murphy lost me, however, when he suggested the alternative of banning the practice of organ donations from strangers that permit the donor to pick a recipient.

The number of individuals currently waiting for a kidney transplant in the United States is nearly 100,000. This year, only about 100 of these individuals will receive kidneys from living strangers -- about half from anonymous living donors and half from people like me who sought out their donors on the internet. The Matching Donors website is responsible for a total of only 47 organ transplants -- hardly a cause for much ethical hand-wringing when lives are being saved by "biased" donors such as me.

I would respectfully recommend that thinkers like Dr. Murphy put some energy into increasing the number of living donors in America rather than scolding and disempowering those of us who stepped up to help.

Saturday, June 9, 2007

Radio Netherlands Interview with Tom & Brenda

Radio Netherlands super-smart show, "The State We're In" posted their "Episode 2" for free download in MP3 format. It is a 1 hour show that features an interview with Tom Simon (aka me) and Brenda Lagrimas regarding our kidney match made in heaven.

Our segment begins at the 12:40 mark of the program, and lasts a little over 7 minutes. Later in the show, an evolutionary biologist tries to explain why I did what I did as if I were a chimpanzee throwing poo at the wall of my cage. Wierd.

Here is the link:

I was able to download it into my computer (and my iPod) by following the following steps:

1. Go to the link above
2. Right click on the "Listen to the Show (MP3)" link
3. Choose the "Save Target As..."
4. Download the MP3 file into your computer
5. After the file downloads, open it in your favorite media player program (iTunes, Windows Media, etc.)

Alternatively, here's the direct link to the MP3 file. I couldn't make it work, but maybe you'll have better luck:

I'm very pleased with the way Radio Netherlands edited the program. Let me know what you think!

Monday, June 4, 2007

The Kidney Chronicles in The New York Times

The following article appeared in Sunday 6/3/2007 New York Times. They used a quote from this blog at the end to lighten the piece up, I suppose:


A Television Audition for a Part in and of Life

THERE was outrage aplenty last week when a Dutch television network said it would broadcast a reality show featuring three patients competing for a kidney from a terminally ill woman. Viewers were to send text messages to help the woman, identified only as Lisa, make her choice.

Government and health officials in the Netherlands tried to find a way to stop the show, or at least the subsequent transplant. Disgusting, people around the world said. A tasteless stunt.

Toward the end of the broadcast Friday night, it was revealed that the show was indeed a stunt. While the contestants really did need kidneys, “Lisa” was not terminally ill, she was an actress with no plans to donate one, and the contestants knew it. But by then the show had accomplished its mission: to raise consciousness about the desperate shortage of organ donors.

The whole episode pointed up a certain fuzziness about the donor debate. What, exactly, was so off-putting about the show? Was it that the premise was unethical, or just tasteless? That a terminally ill woman would choose a stranger to receive her kidney, or that she would make her choice on TV? That somehow one person — the more attractive? the more charming? — would be deemed more deserving to live?

Organ donation has long been something of a slippery slope. Until the 1980s, when the United Network for Organ Sharing, or UNOS, was established in the United States, organs from cadavers were often allocated less by objective measures of medical urgency than through personal connections and quirky judgments about which recipients were most worthy.

Now, most cadaver organs go to those on the UNOS waiting lists, with matches made on the basis of medical factors like the size of the organ and blood type, the urgency of the patient’s need, the length of time spent on the list and the distance between donor and recipient.

But since the supply of organs is much smaller than the demand, thousands of patients die each year, waiting.

Since 2001, however, organ transplants from live donors, who usually pick their recipients, have outpaced those from cadavers; organs from live donors tend to do better, too. Increasingly, desperate patients are seeking live donors — through the Internet, creative advertising, or, even on television, a development that has made some bioethicists squeamish.

“I find this kind of show tawdry, turning a serious medical decision into a sideshow, based entirely on entertainment value,” said Paul Root Wolpe, a bioethicist at the University of Pennsylvania and president of the American Society of Bioethics and Humanities, who was interviewed before the hoax was revealed.

At the same time, some transplant experts noted that “The Big Donor Show” (“De Grote Donorshow,” with the O in “show” shaped like a kidney) was in some ways similar to competitions — not hoaxes — that take place quietly, off camera.

“It’s not all that different from what’s happening on the Internet, on sites like, where people looking for organs post their pictures and their stories, hoping a potential donor will choose them,” said Jeffrey Kahn, director of the University of Minnesota’s Center for Bioethics. “Or there was a guy in Houston who bought a billboard saying he needed a liver, and a family called after their daughter was in a car accident and said they wanted to donate to him.”

On, which warns potential donors that it is illegal to receive payment for their organs, patients looking for a live organ donor pay $295 a month, or $595 for the lifetime of the site, to register.

In one posting last week, labeled “Grace Needs a Healthy Active Dad,” the patient describes himself as a 41-year-old self-employed geologist, “caring husband and father of a beloved 11-year-old girl,” who loves “Labrador retrievers, camping and hunting, water-skiing and Nascar racing” and does not smoke or drink.

Online or on camera, such approaches to organ donation raise concerns.

“I think we’d reject as a matter of morality and equity that the prettiest people, the people with the best story, or the ones who can pay the most, should get access to this very scarce resource,” Mr. Kahn said.

In a handful of developing nations, kidney selling is not so uncommon, and there are those in the United States who argue that such transactions should be legalized, as mutually useful exchanges between rich and poor.

Most living donors donate when a loved one is in need. “It’s traditionally viewed as acceptable for a living organ donor to designate a relative or friend as the recipient,” said Dr. Mark Siegler, director of the MacLean Center for Clinical Medical Ethics at the University of Chicago. “That’s been true since the first successful transplant in 1954. Then 15 years ago, we broadened the category to include not just those related by blood, but those with an emotional relationship. Some programs now let people donate an organ to a particular stranger.”

And some transplant programs help arrange family swaps, in which a member of one family donates an organ to a medically matched member of another family, and vice versa.

The vast majority of cadaver organs, however, are given anonymously to those on official waiting lists: in the United States, there are almost 100,000 people waiting for organs, the vast majority for kidneys. But even in America, that doesn’t mean that families never direct who should get an organ from a dead relative.

“You’re not supposed to be able to, but it happens all the time,” said Mr. Wolpe, adding that while he had no problem with a family directing a cadaver donation to a sick relative, there was a very real danger that extending directed donation to strangers could distort the system. “We don’t want a system where families can say, ‘I want to donate to a white person, or a Jewish person.’ ”

Or, for that matter, a telegenic person: adding considerations of entertainment value to an already murky area ratcheted up the concerns.

Those behind “The Big Donor Show” said from the start that their goal was to highlight the Netherlands’ acute shortage of donors and prod the government to encourage more donations. BNN, the company that broadcast the show, scheduled it for the fifth anniversary of the death of Bart de Graeff, a former BNN director. Mr. de Graeff died of kidney failure at 35, after spending years on a waiting list.

“We know that this program is super-controversial and some people will think it’s tasteless,” said Laurens Drillich, the chairman of BNN. “But we think the reality is even more shocking and tasteless.”

The shortage of donors is less acute in the European countries that have “presumed consent” to transplant organs from a cadaver, unless the deceased specifically forbade it. In the United States, though, as in the Netherlands, donors or their families must consent to organs being harvested for transplant.

Endemol, the company behind “The Big Donor Show,” has produced reality TV hits like “Big Brother,” in which contestants are recorded living together in a house, and “Fear Factor,” which features bug-eating contests and rat-filled pits.

Some people who have been live donors or have received organs from live donors said last week that a touch of that sensationalism might not be a bad thing, if it put a human face on the need for organs and on those willing to make a relatively low-risk kidney donation.

Tom Simon, a Chicago F.B.I. agent whose blog, The Kidney Chronicles, tracks his recent kidney donation to Brenda Lagrimas, a woman he found on, wrote: “The game show thing has a certain perverse appeal to me. How many centipedes do you think I could have gotten Brenda to eat on television for her to win my kidney?”

Friday, June 1, 2007

The State We're In & Freakonomics

Brenda and I recorded a great show yesterday for Radio Netherlands. It will air in the EU next week. I'll link when it posts as a podcast. The show is called "The State We're In," and it seems like a Dutch Version of "This American Life." I was amazed that the super-cool host, Jonathan Groubert (aka Ira Glass in wooden shoes), was able to perfectly mimic an American accent.

He then told me he was from Brooklyn.

I then told him the Yankees suck.

The link for the show is:

My episode on "Altruism" airs next week.

Also, the guys behind the bestselling book, Freakonomics, have a great blog at that has been trying to solve the kidney shortage through rational thought and open debate. My kidney donation to Brenda (and this blog) was mentioned in their regular "Freakest Links" feature. Here's the link:

Saturday, May 12, 2007

My Australian Kidney Interview

I was recently contacted via email by Esther Han, a Sydney, Australia-based journalist for a publication called "Precinct" who is writing a story about internet kidney donations. She will be using my kidney donation story as part of her article.

Here are some of the questions she posed to me and my answers. I have no idea how much of it she'll use in her piece.

1. What would you like to say to the general public about living organ donors who donate over websites (I believe some people find the Internet a 'dangerous' place)?

Before the advent of websites such as, people interested in donating an organ only had two choices:

1. Find someone in need yourself
2. Let the hospital choose someone for you

The internet empowers the donor to make his/her own choice as to whom benefits from the gift of an organ donation. I also feel that as more people take advantage of the internet as a means to match donors and recipients, you will see less donors “chickening out” at the last minute. Being able to put a face and name with your intended recipient creates empathy and accountability – two major deterrents to backing out of this life-saving act moments before surgery.

2. What sort of person does it take to do what you have done, donate an organ to a complete stranger?

Throughout this process, I’ve made contact with several other living donors who have chosen to donate kidneys to people with whom they had no prior relationship. None of them, including myself, seemed to be remarkable or heroic characters ripped from the pages of “Lives of the Saints.”

Instead, I think all living donors are persons who base their lives on facts and reason coupled with a keen sense of cost-benefit relationships. In short, we are all members of the reality-based community.

The greater public is saddled with the incorrect impression that donating a kidney is a very risky procedure with long-term health risks to the donor. However, ten minutes of research on the internet or a discussion with a any medical professional in the field of transplant will tell you this is not true. The reality is that the donor surgery is performed laparoscopically with small incisions for a quick recovery and minimal pain. And statistically, living donors with one remaining kidney are no more likely to have kidney problems than persons with both kidneys in tact.

Living donors of all stripes have taken the time to learn the facts about the procedure and its aftermath. As such, living donors are willing to accept this minor risk of surgery (“the cost”) with the tremendous upside of saving another’s life (“the benefit”). Those of us who chose to donate to a stranger are no more benevolent than those who choose to donate to a loved one. We just didn’t know anyone who needed a kidney when we made the decision to donate.

3. How much do you encourage it?

I would highly encourage everyone to learn the facts about living kidney donations. The risks are low, and the benefits are great. There is a website called that contains the testimonials of folks like me who have gone through the procedure as well as detailed information about what the donation process entails.

4. What would you like to say to those who feel that their only hope is through websites like matchingdonors, but have been waiting for over a year?

You want to be truthful about your medical situation, but also provide enough personal information about yourself, so readers can empathise and identify with you. It may seem shallow, but posting a nice photo of yourself is a must – people find it easier to relate to people they can see.

For me, I was less concerned about the direness of my recipient’s medical condition than I was about what I felt she could contribute to the world if she were in good health. If you have dependents or a “reason to live,” this should be emphasised more than the painstaking detail of your medical condition. I take it for granted that you are not seeking a kidney transplant for recreational purposes. Now, tell me about yourself.

5. There have been some ethical concerns raised about sites like matchingdonors including, emotional pull, potential recipients who might exaggerate or misrepresent themselves in their profile or contributing to an increasingly unfair system, what is your response to this?

I see nothing wrong with letting my emotions, preferences, and biases shape my decision regarding who gets my kidney. No one is troubled if I choose to give my other assets (i.e. cash) to people and causes I support. Why do people short-circuit when I decide to give my kidney to a person I support?

The idea that there’s this grave danger that internet fiends will con donors into giving up their kidneys to unsuitable recipients is pure nonsense. First of all, the recipients post because they need a kidney. No one is going to accept a kidney transplant unless they have a dire medical condition. Furthermore, the doctors will not perform the procedure on anyone unless there is a medical need.

I suppose it is possible that a potential recipient might lie about their dependents, their religion, or the emotional aspects of their lives to lure in sympathetic donors. To that I say: let the donor beware. Unlike non-directed donors who have no opportunity to do any due diligence regarding their recipients, internet donors are holding all the cards. The donor can request a sit-down with the recipient and his/her family, ask to see medical records, and do everything short of accepting cash (in America) before they agree to move forward with the procedure.

We need to dispel the myth that the hospital committees who choose which recipient on the list is “next up” are using a cold and calculating formula to make this decision. My sources tell me that it’s more like jurors deliberating a courtroom case and allowing their own feelings and biases – coupled with the facts – to decide who gets the next kidney. If you are comfortable letting this committee impose their values in making the decision about who gets your kidney, I have no problem with that. But I fail to see any moral dilemma behind imposing my own values in deciding whose life I want to save.

Finally, if anyone is placing themselves at risk of exploitation in using the internet as a conduit for organ transplant, it is the recipient. After posting her appeal on, my recipient, Brenda, was barraged with emails from con-men, immigration opportunists, and charlatans seeking to steal money or benefits from her in exchange for the promise of a kidney. She had to sift through all of this “kidney spam” before she could even find my email offering to discuss the matter further.

Wednesday, May 2, 2007

Radio Interview with My Kidney

I will be a guest on “The Roe Conn Show” on Chicago’s WLS-AM 890 at 6:10 p.m. (Chicago time) on Thursday 5/3/2007 discussing my kidney donation. Out-of-towners interested in listening (Hi Mom!) can catch the web audio stream at

Monday, April 30, 2007

The Sundance Kidney

I returned to work today, and it felt great.

#1 Most Common Question Asked: How are you feeling? (Answer: “Fantastic! You?”)

#2 Most Common Question Asked: When are you having that surgery again? (Answer: “Uh, 11 days ago…”)

I also started exercising. I ran about a mile this morning, and it felt pretty good. I’ll stick to moderate cardio fitness for the next month since I can’t lift anything substantial until I heal more. Every now and then, my torso screams with pain making me realize that it has been 16 hours since I last took Tylenol. This is a worthwhile reminder that I’m not Superman and need to take it easy.

I spoke to Brenda, who is doing well. Her new kidney is getting quite the workout since she is drinking a ton of water. It seems to be operating just great, so there is little risk of her returning it to me. Her abdominal incision was a lot more serious than mine, so it will take her a lot longer to recover.

Finally, Brenda’s family in Hawaii and the folks at both sent me a ton of “get well soon” sweets which I have been eating like a pig in the fathouse. I’m convinced it is a conspiracy to give me Type 2 Diabetes, so I’ll need a kidney transplant myself.

My newfound morbidly obese life will become just like an O Henry story or an episode of Alfred Hitchcock Presents.

“Did you hear about that jackass who gave away his kidney only to find himself…”

Wednesday, April 25, 2007

Creatinine from the Black Lagoon

I met Brenda at the hospital today (six days post-transplant) for our post-operative check-ups. Brenda looks and feels great. We are both off of our narcotic (and delicious) painkillers in favor of (plain, boring) Tylenol. My wounds (three of them) from surgery are all healing well.

I was mostly interested in finding out our current creatinine levels.

Allow me to explain:

The functioning of your kidneys is best measured by testing the level of creatinine in your blood. A low level is good and indicates good kidney functioning. A high level is bad and indicates kidney failure and the need for dialysis and/or a transplant to save your life.

When kidney people talk about your “creatinine level,” it is generally expressed in a single number, such as “1.4.” What this is referring to (in the non-metric U.S.A.) is 1.4 milligrams per deciliter.

Normal levels of creatinine in the blood are approximately 0.6 to 1.2 milligrams per deciliter.

A person with only one kidney may have a normal level of about 1.8 or 1.9. Creatinine levels that reach 2.0 or more in babies and 10.0 or more in adults may indicate the need for dialysis to remove wastes from the blood.

Before my surgery, my creatinine level was 1.2. Six days after the surgery, it is 1.6. I’m told this is normal. This number will continue to decrerase as my remaining kidney swells (with pride) over the next several weeks, and increases its filtration rate.

The increased level of creatinine in people suffering kidney failure causes their brain function to diminish. They often feel “cloudy” in their thoughts.

Prior to surgery (and during her kidney failure), Brenda’s creatinine level was above 9.0. Immediately following receiving my kidney, her creatinine level has plunged to 1.0.

She says her mind is no longer cloudy.

I say my kidney has made her a genius.

She says I shouldn’t get carried away.

Monday, April 23, 2007

Kidney Donation Timeline

Many people have expressed surprise how quickly the whole kidney transplant transpired. Here is the comprehensive timeline detailing how the whole thing unfolded. I put it together using my Palm and email archives.

January 29, 2007 While my wife was out of town, I read an article on Reason Magazine’s “Hit and Run” blog about kidney donations, a topic I had been interested in for some time. It linked to an article called “Here’s Looking At You Kidney” by former Reason editor, Virginia Postrel, a kidney donor herself. Her article mentioned I contacted Ms. Postrel, via her husband, to establish who pays for the donor’s operation. She promptly responded that the recipient’s insurance pays for the donor’s medical costs. She also made herself available to answer my myriad of dumb questions. I began an exhaustive amount of web-based research into the nature of the surgery and learned two important things:

1. The surgery itself was a routine procedure with a quick recovery time.
2. Living with one kidney was exactly the same as living with two kidneys.

January 30, 2007 I spoke with a friend who is a very talented surgical transplant nurse at Rush Hospital in Chicago. She put me in touch with the transplant coordinator for the hospital, who was a real moron. Eventually, I was able to get my point across to the pinhead on the phone that I wanted to donate my kidney to a stranger on Rush’s transplant list. She informed me that they didn’t do that at Rush, but she believed that Northwestern Hospital in Chicago had such a program. I made an appointment with Northwestern Hospital’s Transplant Department for an orientation session. Unlike Rush, Northwestern’s staff was friendly and helpful every step of the way.

January 31, 2007 I discuss the possibility of donating a kidney with my wife, Lisa. After being presented with the facts, she was receptive to the idea. We looked at the Matching Donors website and saw Brenda’s listing. We also watched a You Tube video featuring Brenda on a local newscast. The news story indicated that Brenda had found a donor from Texas who had stepped forward to donate a kidney. Lisa and I discussed at length the ethics of choosing someone from vs. simply giving my kidney to the next person on the hospital’s waiting list.

February 2, 2007 I attended an orientation session at Northwestern Hospital in a room full of donors. I was the only donor there without a recipient. Dr. Talia Baker (who later removed my kidney) did a PowerPoint presentation answering all questions and addressing concerns. Following the presentation, I had blood drawn to establish my blood type for possible matching. I began the paperwork to become a “non-directed” donor, meaning that I would give to whomever Northwestern felt was most needy.

February 3, 2007 I sent an email to Brenda Lagrimas, the woman whose profile I had seen on to see how she was doing. She didn’t respond immediately, so I moved forward with Northwestern’s Non-Directed Donor program. I made my second appointment with Northwestern for donor screening.

February 8, 2007 Brenda finally responds to my email, and I learned that her Texas donor had fallen through, and she was searching for a suitable donor who wasn’t going to jerk her around. We set up a phone conversation for the next day.

February 9, 2007 I spoke to Brenda on the phone and told her that if we were a match, I’d gladly give her my kidney. I contacted Northwestern Hospital to change my donation from non-directed to Brenda as my recipient.

February 15, 2007 I had my next appointment with Northwestern where I gave more blood for testing, and they performed a chest x-ray to establish that I do, in fact, have two kidneys. I passed this phase of screening.

March 4, 2007 I collected my pee in a jug for 24 hours for testing at Northwestern. This was utterly humiliating.

March 5, 2007 I turned in my jug of piss at the hospital. The hospital had me meet with a Transplant Social Worker to ensure that I’m sane enough to donate a kidney. I also met with a transplant surgeon who answered my new questions about the procedure. The hospital performed a CT Scan of my kidneys to ensure that the plumbing was appropriate for transplant. I passed every step of this phase.

March 20, 2007 Brenda and I heard that we were cleared for transplant. We chose April 19 as our transplant date.

April 2, 2007 Brenda and I met for the first time at Northwestern at our pre-operative doctor’s appointment. We were shown a video that answered nearly all of our questions about “k-day,” and we met with the fantastic Lori Gardner, Northwestern’s Transplant Coordinator, who answered the rest of our questions.

April 17, 2007 My co-workers threw a surprise party for me at lunch to wish me luck. Interviews with Fox News, The Chicago Sun Times and The Chicago Tribune took place.

April 18, 2007 My last day at work before the surgery. The press barrage hit the papers and television.

April 19, 2007 Surgery day. I was under the knife around 11:30 a.m., awake around 2:00 p.m. The surgery was successful and painless. Drugs regulated post-op pain. I was up and walking later that night.

April 20, 2007 Lots of walking around the hospital. Peeing on my own was very difficult that day, but after succeeding, I was sent home around 3:00 p.m.

April 21, 2007 Brenda was sent home. Her new kidney was functioning perfectly.

April 22, 2007 More recovery at home. Fox News aired a follow-up story celebrating Brenda’s return home.

April 23, 2007 I walked a mile with my son, returned to volunteering at the National Runaway Switchboard. This was my first day without painkillers other than Tylenol.

Friday, April 20, 2007

Mission Accomplished

Well, I’m home now following yesterday’s kidney donation.

The surgery itself was remarkably fast. I’m told that thanks to the technical proficiency of Dr. Talia Baker, my left kidney was removed in about an hour. Of course, for all I knew, it could have been a week as I was unconscious the whole time. Pain meds upon my awakening made the whole thing a non-event.

(Trivia: My entire Transplant Team was female – surgeon, anesthesiologist, physician’s assistant, nurse, and resident. “Ladies and gentlemen, The Kidnettes.”)

The best news of all was the fact that Brenda’s body accepted my kidney (or the kidney formerly known as my kidney), and it began making urine before she was even stitched back up. Her incision was much larger than mine, so her recovery time will be longer, and she will likely go home tomorrow. We were both up and walking shortly after surgery.

I was pretty groggy and anti-social last night, and I slept poorly due to the octopus of I.V. and catheter tubes. All of the tubing was removed around six this morning, and I shed my hospital gown in favor of street clothing. I cleared my head by walking around the hospital and entertaining guests at my hospital room after-party.

Before I was able to leave the hospital, I had to urinate on my own (just like my three year old son just learned to do). This was the topic of lots of complaining and whining on my part (“I can’t do it. I can’t go potty.”), but the nurse assured me that I could, in fact, make tinkle-tinkle, and then mission was accomplished.

I spoke, via phone, with the founder of, and he assured me that any recipient who is unable to pay the fee for a listing could get listed for free. It was clear that he was a good-hearted man who cared a lot. He said he loses money on the site, but he believes in the cause. Brenda and I had the 42nd successful transplant brokered through the site. He also said that the media blitz surrounding our procedure resulted in 32 new people stepping forward to register as donors through the site.

Again, mission accomplished.

Finally, thanks to all of you who wrote or called me over the past few days. Corresponding with you took my mind off things and helped pass the time as I was waiting to pass urine. I owe you one.


My favorite local blog,, wrote a very nice entry on my donation:

We Want You(r Kidney)

Tom Simon does a lot of things right. He investigates white collar crimes for the FBI, volunteers for a youth crisis hotline, biked thousands of miles for AIDS charities, and donates his organs to perfect strangers … just because he can. But whatever you do, don't call him a hero.

According to Simon's blog, The Kidney Chronicles, his desire to "help others and alleviate suffering" led him to consider handing over one of his kidneys. He initially approached the transplant department at Northwestern Memorial Hospital to be a "non-directed" donor — meaning that he wouldn't have any say in who received his kidney. While this would be all well and good, he also discovered the option to pick the recipient through a website where hopeful recipients post profiles telling their story and need for organs. That's where he found Brenda Lagrimas.

For years, Lagrimas, 31, has been receiving dialysis three to four times a week. Kidney failure put her on the waiting list for a kidney, along with over 70,000 others. Simon chose Lagrimas because she is young, with the hopes of starting a family, and is a fellow in the law enforcement world.

Simon makes a point to say that he is not crazy or heroic. He is merely doing a public service. He stresses that this procedure poses very little risk to the donor with virtually no long-term side effects. The remaining kidney simply picks up the slack, and there you go! You're out there making urine just like all of the two-kidneyed folks.

Here at Chicagoist, we have family members who are alive today due to the generosity of organ donors (hey, Chris!), so we couldn't be more thrilled to hear about this. People making the decision to hand over their organs after death is fantastic, but live tissue donation? That's where it's at. While organs from cadavers greatly help the cause, live tissue donation offers a better chance of transplant success. And, frankly, not enough people allow for the use of their organs once they pass on.

Now, we don't expect everyone to run out and get their kidney sliced out. But, c'mon, at least sign those licenses and make sure to express your donation wishes to your family. You really can save a life.

Thursday, April 19, 2007

Nice Coverage

Can't sleep. Part nerves. Part "bowel preparation" (don't ask).

My surgery was pushed back two hours, so family waiting on the "he's okay" call shouldn't worry if there's no news until noon.

Chicago's Fox Affiliate did a nice story last night that is available online:

If that link is no good, simply go to, click on "news" and do a search for "FBI" and "Kidney," and you should find it.

My friend and, er, Kidney Mentor (?), Virginia Postrel, did an informative blog post mentioning my donation. It can be read at:

She makes the point that I've been trying to convey throughout this press onslaught:

"...donating a kidney is not an especially risky procedure or unthinkable sacrifice. That doesn't mean everyone should run out and give someone a kidney--any more than everyone should take a job in law enforcement. But we need to start thinking of kidney donors as normal people taking reasonable risks for great benefits, not as crazy or heroic."

I'll plead guilty to crazy but not heroic.

Wednesday, April 18, 2007

Press Coverage

FBI agent a reluctant hero

April 18, 2007


He's an FBI special agent, a father, a crisis hotline volunteer, and -- on Thursday -- he'll donate a kidney to someone he just met.

But Tom Simon doesn't want to be called a hero.

Simon, 37, says he wanted to make a difference in someone's life and show others that donating an organ isn't difficult to do.

He looked on a donor Web site,, and found Brenda Lagrimas' profile.
She was young, wanted to start a family and, like him, was in law enforcement. To Simon, she was the perfect match.

"I'd like to draw attention to the fact that this isn't a giant sacrifice in my life," Simon said. "Brenda is going to die if she doesn't get a kidney. I have one to spare. I'm not being a hero. This is social justice."

Simon started with the FBI 12 years ago and investigates major financial and white-collar crimes. He's married and has two children, ages 4 and 3. He made the decision after many long talks with his wife, he said.

Donating an organ isn't as daunting as most people think, Simon said. He'll undergo laparoscopic surgery and expects to be home within a day and, after a rest at home, back at work by May 1.

'I will finally be free'

Kidney donations are the most common type of organ donation. Experts say the risk to the donor is low because the remaining kidney will pick up the necessary work.

Lagrimas, 31, of Evanston, was diagnosed with kidney disease in 2003. She works as a victim witness specialist for the Cook County state's attorney's office. In 2004, she developed congestive heart failure. Her malfunctioning kidneys drain her energy. She gets dialysis three times a week for 3.5 to 4 hours each session.

She says she thinks transplant surgery at Northwestern Memorial Hospital on Thursday will change her life. "I will finally be free," she said.

Lagrimas also has her friends at work to thank for matching up with Simon. For her 30th birthday, colleagues collected more than $600 to buy a lifetime ad on matching
Sites like are controversial because they reward recipients who put on the best marketing vs. those with the greatest medical need.

Simon initially walked into Northwestern and offered to be an anonymous donor. But he later changed his mind and started surfing the Web.

"I would have wanted the person to be exactly like Brenda," Simon said. "She was my dream recipient."

Coincidentally, Lagrimas was also on Northwestern's wait list.

Her time on the Web site was an emotional roller coaster, she said. People showed interest in helping, then faded. Others tried -- illegally -- to sell her their organs or asked that she help them into the country in return. One man from Texas corresponded with her for eight months, then disappeared.

When Simon e-mailed her, she didn't even respond right away, thinking it was just another false hope. She couldn't believe it when he turned out to be legit.

"He doesn't see it, he's practically saving my life," Lagrimas said. "He's a hero to me. He's my hero."

© Copyright 2007 Sun-Times News Group

Going beyond the call: FBI agent to give kidney
Recipient is a woman who also has a link to law enforcement

By Jeff Coen

Tribune staff reporter

Published April 17, 2007, 9:15 PM CDT

During her job helping victims of domestic violence navigate the Cook County court system, Brenda Lagrimas could sometimes forget there were very good people in the world.

That is until she met Tom Simon.

A 12-year Chicago FBI agent, Simon will donate a kidney Thursday to Lagrimas, a woman he never met before going online to look for someone to give a kidney to earlier this year.

"He's just an awesome guy," Lagrimas said Tuesday. "I totally lucked out."

Lagrimas, 31, of Evanston suffers a type of nephritis that created scar tissue and left her kidneys unable to filter toxins normally, and she has been on dialysis for a few years. Simon, 37, had become interested in being a living donor, and the two found each other on a Web site that helps link those who need organs to those who want to give them.

Simon, a married father of a young daughter and son, was already a regular blood and bone-marrow donor when he became interested in going further."

The thought of being able to save someone's life by donating a kidney has been an attractive option to me," Simon said.

It's a low-risk proposition for the donor, and obviously has a tremendous upside for the recipient, said Simon, who believes he has an ethical obligation to be a living donor."If you have the ability to help someone out with very little to ask of yourself, I feel you should do it," he said.
He said he was especially happy to find a recipient who is a younger person who wants a family someday, and he was pleased that Lagrimas has a connection to law enforcement. Lagrimas has spent eight years as a victim-witness specialist for the Cook County state's attorney's office.

She first learned of her condition in 2003, and it progressed until she learned she needed dialysis in May 2004. No one in her family was a suitable donor, so for her 30th birthday in 2005, her co-workers bought a lifetime placement for her profile on Simon e-mailed just as Lagrimas was dealing with the disappointment of not hearing back from someone in Texas who had been testing to see if he was a good donor.

After a few messages, they spoke on the phone. "He said he would try not to put me through the worst job interview ever," she said, remembering Simon asking her a few questions about her life and her past. "I felt pretty comfortable knowing he worked for the FBI."

The pair will have surgery at Northwestern Memorial Hospital, and Simon said he expects to be back at work May 1 investigating white-collar criminals.
Copyright © 2007, Chicago Tribune

Monday, April 16, 2007

Meeting Brenda

I met Brenda and her mom at our doctor's appointment on April 2, 2007. As expected, Brenda was kind, charming, and appreciative. Her mom was a sweet lady who was very emotional and grateful beyond words. Meeting Brenda solidified my decision to help her.

I'm donating a kidney to a stranger on April 19

Entry Date: March 24, 2007

On April 19, 2007, I will be donating one of my kidneys to a stranger. Any questions?

What made you decide to donate a kidney?

There are currently about 70,000 people in the United States on the kidney transplant waiting list. However, there are only about 13,000 kidneys available for transplant each year. About half of these come from cadavers, and the other half come from "living donors" such as me.

Okay, that's very sad, but why you?

The quick answer is that I am donating because I have a spare kidney, and there are people out there who will die or, at the very least, suffer on dialysis unless they receive a transplant. I think that saving a life would be a very powerful experience.

Those who know me should not find this totally out of character. The reason I went into law enforcement, biked thousands of miles for AIDS Charities, stopped consuming animal products, and volunteer my time at a youth crisis hotline is because of my desire to help others and alleviate suffering. Donating one of my kidneys on April 19 is simply the next step in what I hope will be a long life of public service.

As many of you know, I am a religious, but deeply flawed, Catholic. I like to think that I come from the "social justice" wing of my faith as opposed to the "intolerant jerk" wing. This also informs my decision to donate a kidney.

What does your wife think?

Lisa has been very supportive. I would not be donating if she felt strongly that I shouldn't.

What does the surgery entail?

The donation of a kidney is laparoscopic surgery, meaning small incision and quicker recovery. I'll be out of the hospital on the next day, back at work in two weeks, and back to normal in a month. The surgery is no more dangerous than any procedure done under general anesthesia.

Are there long term negative effects of living with one kidney?

In short, no. There is no scientific evidence in 50 years of living kidney donations that there are any ill effects to living with one kidney. Within five weeks of donation, the remaining kidney swells in size and increases its filtering power (the "glomerular filtration rate") to match the power of two kidneys. In short, I'll have a single super-kidney instead of two simply adequate kidneys.

What if something happens to your remaining kidney?

My family has no history of kidney disease. When kidney disease occurs, it nearly always strikes both kidneys at the same time. It's not like one kidney fails and you find yourself knocking on wood, thankful that you've got a spare. If I should develop kidney disease, I will need treatment or a transplant – just like I'd need if I had two kidneys.

What if one of your kids needs a kidney?

This is the best argument I've heard against donating. That said, I can't justify not saving a life today because it might inhibit my ability to possibly save one in the future. My wife will have a spare kidney for them, and we both have loving families who may be willing to help if one of my kids is in need of a kidney.

Are you able to get paid for your donation?

No, that would be illegal. The only incentive I am permitted to receive is the warm feeling from helping another. Well, that is not exactly true. If a kidney donor needs a transplant, they go straight to the front of the line on the kidney transplant list, which seems like a very fair deal to me.

As a public policy matter, I have no problem with donors selling their spare organs to needy recipients. I wouldn't do it, but I think anything we as a society can do to increase to donor pool is a good thing.

Why not just sign your driver's license?

Living donors have better kidneys than dead ones. The likelihood of a successful donation is increased greatly by a living donation. That said, anyone who signs their drivers license is okay with me.

Who is your kidney recipient?

I walked into the kidney transplant department of Northwestern University Hospital a short while ago and told them I wanted to be a "non-directed" kidney donor. This means that I was prepared to allow the hospital to choose my recipient from their transplant waiting list.

I immediately began to have misgivings about this approach. What if my kidney wound up inside a real jerk? Or a registered sex offender? The lion's share of people on the kidney donation lists suffer from diabetes, and many of them have Type 2 diabetes that arose from obesity and a sedentary lifestyle. Furthermore, I felt strongly that, all things being equal, I'd like to see my kidney go to a young person who may be able to enjoy it for a long time before their natural death.

Non-directed donors have no control or input into who gets their organs. The donor is not permitted to know the identity of the recipient until several weeks after the surgery – and then only if both sides consent to the disclosure. A committee inside the hospital makes the decision about who on the list gets to be the recipient, and a confidential source I have inside the transplant department of another hospital told me that the panel is fraught with its own biases.

I read an article by Virginia Postrel, a libertarian writer who I respect greatly, who donated a kidney to her friend-in-need. The article was cleverly titled, "Here's Looking at You, Kidney," and here is the link:

In the body of her excellent article about the process, Virginia mentions a website called where people in need of organs (kidneys mostly) post their profile and story in hopes of finding a donor.

It's a bit creepy since the site resembles or other dating sites. Yet unlike, in a successful Matching Donors hook-up, you don't get lucky on your "date" and you wake up missing a piece of yourself, which, come to think of it, recalls my single dating life more than I care to remember.

In the world of Bioethics, sites such as Matching Donors are very controversial because they tend to reward people with the best self-marketing skills rather than with the greatest medical need. A lifetime ad on the site soliciting donors costs the recipient about $600. On the other hand, non-directed donorship strips the donor of any input whatsoever into the 'who gets my guts" decision, and that strikes me as quite unfair.

I spent some time searching the Matching Donors site until I found the posting of a Chicago woman named Brenda. Here is the link to her posting (although I expect this link to disappear soon):

I also found a You Tube video about Brenda that I'll post below:

The direct link is:

I felt a great deal of empathy for Brenda. She is young, non-diabetic, and works in law enforcement as a domestic violence court victim advocate for our local prosecutor's office. She's also experiencing severe kidney failure combined with complications arising from dialysis.

I continued to struggle with the dilemma of non-directed donorship vs. finding my own recipient on the web. My wife and I discussed the morality of "playing God" and deciding who lives and who dies. Finally, I decided to go with Brenda for the following reason: if I had let the hospital pick my recipient, I would've hoped that the recipient's personal story be just like Brenda's story. Given that reality, the final decision was easy.

I reached out for Brenda via email and began a dialog with her and found her to be a delightful girl. We spoke on the phone, and I informed her that if our blood types matched, I'd be proud to give my kidney to her. I did everything in my power to put her mind at ease, so she wouldn't feel like she was sitting through the most important job interview of her life. In any case, she passed. I continued through the clinical screening, and we appear to be a kidney match.

We have not met in person. We have a joint doctor's appointment on April 2 when we will meet for the first time.

What if Brenda's body rejects your kidney?

Then I will feel a real sadness but no regret about my decision. All I can do is all I can do. The rest is up to the doctors, God, and Brenda's body.

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