More than 83,000 Americans are waiting for a kidney transplant. Many of these people will die for lack of a donated organ.
Most live kidney donors give to a close family member. But each year, a small number of people give a kidney to someone they don't even know.
At San Diego's Sharp Memorial Hospital, Kay Wolff sits in a private room filled with orchids and roses.
She's not here because she's sick. Wolff is 72 years old, and in excellent health.
She's recovering from surgery to remove one of her kidneys. A few days ago, Wolff donated it to a complete stranger.
"It's a little extreme to give an organ," Wolff admits, "but I felt extremely motivated to do it. I just felt this is a way to leave a legacy, and to really help someone in an important way."
It took her years to decide this was the best gift she could give.
"Some people give money, and some people give their time," Wolff points out, "but I thought this is something that I thought was significant and important, and I think it's a time to think about donating an organ."
None of her family needed a kidney. Wolff had tried to donate to some friends who had kidney disease. But she was never a good match. So she decided to donate to a perfect stranger.
That lucky person is Zeny Pruna. She's been on kidney dialysis for the past six years.
Pruna came out of the transplant surgery with flying colors.
"When I wake up, they say that the kidney is working already," Pruna recalls. "That's a miracle for me, also. I'm very thankful."
Altruistic organ donors are extremely rare. There are only about 100 in the U.S. each year.
Like other people who want to donate an organ while they're still alive, altruistic donors go through a battery of medical tests. Then there's another level of scrutiny.
Cathy Chappell is a social worker with Sharp's kidney transplant team. She puts potential altruistic donors through an extensive interview.
"We're looking at someone to make sure they aren't looking for notoriety, they don't want a lot of publicity about this," says Chappell. "Anybody who wants to have some kind of unusual relationship with the recipient, we're not interested in that. We really want someone who just wants to be, you know, a caring humanitarian."
Chappell says they're looking for a fully informed, stable person whose life won't be adversely affected by the donation.
And she says Kay Wolff made the cut.
"I've been with the transplant center for five years, and in that period of time, we've had numerous people come to us wanting to donate altruistically," Chappell says. "This is the first one who's passed our screening."
There are 17,000 kidney transplants performed each year in the U.S. Doctors say it's a relatively safe operation. But there are risks.
Dr. Robert Steiner is the director of transplant nephrology at UCSD Medical Center. He says potential altruistic donors need to be fully informed.
"If you're going to give a kidney," says Dr. Steiner, "You need to know you have, depending on how old you are and your other circumstances, anywhere from let's say one percent up to six percent risk of going on dialysis some day, and that time would be shortened if you gave a kidney. But you also need to know that you could give the gift and it is possible that a person could leave the hospital with the kidney not working at all."
Steiner says even if it is working, it may not last.
At 15 years, about half of those who receive a live kidney are back on dialysis, and about 4 percent of transplanted kidneys fail after one year.
Still, Kay Wolff is glad she stepped forward. And she'd like to do more. But she's not sure how she can top this.
"I don’t know, but I've been thinking about bone marrow," says Wolff, "And I understand that that's a piece of cake after a kidney."
About 1,500 San Diegans are still waiting for a kidney. With an average wait time of three to five years, some of them will die before they make it to the top of the list.
