Donor Diaries

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One kidney can change many lives—if we let it start a chain. We sit down with Dr. John Friedewald, transplant nephrologist at Northwestern Medicine, to unpack a breakthrough: using a deceased donor kidney to initiate a living donor chain that moves multiple recipients off the waitlist and ultimately delivers a living kidney back to a service member at Walter Reed.

We break down how kidney paired donation works, why non-directed donors supercharge matching, and what changes when a deceased donor becomes the chain starter. Dr. Friedewald explains the military-share pathway, where high-quality deceased kidneys are screened for parity with prospective living donor outcomes, then routed via directed donation to a match in exchange. The recipient’s incompatible living donor pays the gift forward, extending the chain until an unmatched donor returns a living kidney to Walter Reed. Along the way, we dig into logistics, OPO coordination, timing windows, and why this process fits within familiar directed donation workflows.

Fairness and outcomes are front and center. We address concerns about blood type O equity, share early data showing more than double the impact per deceased donor, and discuss how programs monitor blood type flows to avoid disadvantaging anyone on the deceased list. For patients, we explore the real tradeoff between waiting for a theoretical living match versus accepting a filtered, high-quality deceased offer today—especially when months more on dialysis raises risk. With lessons from Italy’s regional rollout and leadership from centers like Northwestern and Michigan, this approach is poised to scale and become a standard tool that magnifies each gift and shortens waits.

Subscribe, share this episode with someone curious about organ donation innovation, and leave a review with your biggest question about deceased donor–initiated chains. Your feedback helps more people find these life-saving ideas.
Links
Northwestern Medicine Transplant
The Alliance for Paired Kidney Donation
Walter Reed Transplant
Military Share Deceased Donor Initiated Chains (American Journal of Transplantation) 
Utilization of Deceased Donor Kidneys to Initiate Living Donor Chains (American Journal of Transplant)
Kidney Paired Donation Chains Initiated by Deceased Donors
Donor Diaries Website
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GiftWorks Website
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In this episode of Donor Diaries, we sit down with transplant recipient Wilson Du and living kidney donor Amy McCann, two people whose stories intertwine through determination, community, and the belief that choosing life is a daily practice.
Wilson spent five and a half years on dialysis before receiving his transplant in 2022. After a doctor told him he needed to lose 100 pounds or forget about a transplant, he confronted the shock, the shame, and the painful first steps toward change. The words choose life stayed with him and became the foundation for a journey that carried him from a ten-foot walk to an Olympic-distance triathlon and a mission to help others Outshine Their Pain. Today, Wilson is The Renal Warrior, inspiring patients to fight for their second chance.
Amy first heard Wilson’s story at their community gym and immediately volunteered to be tested as his donor. She was denied for BMI and could have stepped away, but she chose to turn the rejection into resolve. Nearly 100 pounds later, another donor matched with Wilson, yet Amy kept going. She donated her kidney to a stranger on her birthday, transforming her journey into a gift she had fought hard to give. At The Mission HQ, she now leads the Warrior Program, supporting patients and community members who walk through the doors looking for hope.
Together, Wilson and Amy share how Mission HQ became a space where dialysis patients, survivors, and neighbors can move, breathe, and rebuild without judgment. Their message is simple and powerful. Consistency matters more than intensity. Rest when you need to, and then keep going. Small steps count. Hope is built one choice at a time.
Links:
The Mission HQ
Donor Diaries Website
Donor Diaries on Facebook
GiftWorks Website
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Sue Rees returns to share the revolutionary donor protections offered by the Alliance for Paired Kidney Donation (APKD) that are making kidney donation more accessible and equitable for everyone. As Chief Operating Officer with over 25 years of transplant experience, Sue walks us through the comprehensive "Donor Protect" program designed to eliminate financial barriers while safeguarding donors' futures.
We explore how the Alliance reimburses lost wages (up to $10,000), covers travel expenses for both donors and their support persons, and even provides dependent and pet care assistance. Sue explains their innovative "Home Advantage" program, which allows donors to recover locally while their kidneys are shipped to recipients across the country. Most fascinating are the various pledge programs that protect donors and their loved ones: the Advanced Donation Pledge, the Family Pledge, the Friend Pledge, and the Kidney Promise.
The conversation takes a global turn as Sue reveals how APKD's international initiatives are creating life-saving matches across borders. "Our differences can save our lives," she explains, sharing the remarkable story of a Mexican poet with 94% antibodies who found her match in Wisconsin. This global kidney exchange program demonstrates how genetic diversity across populations can be the key to finding matches for highly sensitized patients.
Sue's personal journey into transplant care adds emotional depth to the discussion. After losing her father to glioblastoma, she was profoundly moved by his nurse's compassion: "I want to be that for somebody," she decided. Today, through her work with the Alliance, Sue helps give second chances to patients and families facing medical crises.
Whether you're considering donation or simply curious about advances in transplant care, this episode offers invaluable insights into the protections that make kidney donation safer and more accessible than ever before.
SHOW LINKS:
Alliance for Paired Kidney Donation
Donor Protect
Mexican Kidney Exchange Story
Donor Diaries Website
Donor Diaries on Facebook
GiftWorks Website
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What happens when a transplant surgeon, a Nobel Prize-winning economist, and a willingness to trust strangers come together? A revolution in kidney donation that has saved 20,000 lives and counting.
Meet Dr. Michael Rees and Sue Rees, the power couple behind the Alliance for Paired Kidney Donation. In this captivating first installment of our two-part season finale, we journey back to 2007 when kidney paired exchange was in its infancy and most surgeons believed all transplant surgeries had to happen simultaneously to prevent donors from backing out.
Dr. Rees takes us behind the scenes of his radical experiment: what if we trusted donors to follow through on their promises even after their loved ones received kidneys? The medical establishment warned this trust-based approach could collapse the entire system. Undeterred, Mike vetted the first chain participant over a steak dinner, separated surgeries by weeks instead of performing them simultaneously, and created what would become what is now a common practice- Non‑Simultaneous Extended Altruistic-Donor chains.
Sue shares the heartbreaking reality that confronted her as a transplant coordinator: watching patients remain on dialysis despite having willing but incompatible donors.
Through their pioneering work with the Alliance's sophisticated matching algorithm, the Rees’ have transformed how we think about organ donation, proving that human goodness and trust can overcome medical skepticism and logistical challenges.
Whether you're curious about organ donation, inspired by medical innovation, or simply love stories of human connection, this episode reminds us that our differences—even incompatible blood types—can ultimately save each other's lives.
SHOW LINKS:
Alliance for Paired Kidney Donation
New England Journal of Medicine Article
People Magazine Article
Donor Diaries Website
Donor Diaries on Facebook
GiftWorks Website
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A spiritual calling, a kidney voucher, and two pastors reconnecting after decades apart—this is no ordinary transplant story.

When Jim Pearl was diagnosed with Fabry's disease in 2004, he had no idea his journey would lead him back to Jeff Barker, a seminary friend from the '90s. After five years on dialysis, Jim clung to his mantra: "In the waiting, God is working." Meanwhile, Jeff saw Jim's Facebook post and felt a spiritual nudge to step forward, despite knowing little about kidney donation.

Though not a direct match, Jeff became a voucher donor donating at NYU Langone. His kidney went to someone in the NKR system, and Jim received a kidney voucher due to Jeff’s donation. Just three months later, Jim received his transplant at University of Utah Health.

For both pastors, the experience was deeply spiritual. Jim named his kidney "Gigi" (God’s Gift). Jeff sees the donation as part of Christian incarnational theology—"We often think about giving money, but we can give our very selves."

GiftWorks supported them throughout the journey, helping Jim share his story widely and guiding Jeff through the donation process. Their experience shows how organ donation not only saves lives, but also renews connections, deepens faith, and transforms both donor and recipient.

Jim’s advice for recipients: "Share your story as broadly as possible. It only takes one set of eyes." Jeff encourages potential donors to remember: "Your first yes is not your final yes. Each step requires thought, and each decision matters."

Learn more at yourgiftworks.com and consider how making yourself available to others can be a part of something greater.

Links:
Connect with Laurie Lee
GiftWorks
Donor Diaries Website
Donor Diaries on Facebook
GiftWorks Website
Connect with Laurie Lee