Robin Graves '82 had been on dialysis for three grueling years before her sister offered to donate her a kidney. The women were a good match and her sister had one test left before she would be approved as a donor. The surgery was planned for last October.
That's when her sister stopped returning the hospital's calls. When Graves finally reached her, she said she was working on a big presentation at work and would think about the donation later. After more delay, she backed out.
Devastated, Graves called her longtime friend Martha Hansen '82, whom she met on her first night at Brown back in 1978. They had lived on the same hall in Keeney Quadrangle their freshman year and had kept in touch since college, despite living at opposite ends of the country - Graves in North Carolina and Hansen in Arizona.
"Let me see what I can do," Hansen said. On June 30, she gave up her kidney to untether Graves from her dialysis machine.
The only problem was that Hansen's blood type is A, Graves' is O, and the two are incompatible.
So instead of a direct donation from Hansen to Graves, the pair participated in a three-way indirect exchange arranged through the Alliance for Paired Donation - a kidney love triangle of sorts.
Hansen traveled to Denver to donate a kidney to a woman with her blood type. That woman's husband flew to Alabama to give his kidney to a second woman, whose husband in turn traveled to North Carolina to donate his kidney to Graves. To prevent any donor from backing out once his or her loved one received a kidney, all three operations occurred at exactly the same time.
It was the first three-way kidney swap to occur simultaneously in three different time zones across the United States.
After kidney failure in 2004 due to a rare condition in which proteins build up in the kidneys, Graves went to dialysis three times a week for a grueling four years. "It's hard to describe the level of fatigue that you feel," she said.
For the first year she held a job, often working from 8 a.m. until 9 p.m. with a midday break for treatment. "I would ... just drive myself home and crawl into bed and sleep until morning," she said, leaving her 6- and 8-year-old sons to virtually "fend for themselves."
After a year, she went on disability leave while continuing dialysis. "It's like being in jail," she said. In between sessions, fluid would accumulate in her body and skipping treatment would soon become fatal.
Hansen and Graves submitted their data to the Alliance for Paired Donation in January and waded through tests and paperwork until the date for the surgery was set for June 30. "You expect the doors to just open ahead of you and the red carpet to be rolled out" when you donate a kidney, Hansen said. "Well, it really doesn't feel like it works that way, because (the medical coordinators) are busy trying to protect the health of everybody involved."
Hansen's eagerness to get her friend the transplant overshadowed any nervousness about the procedure. "The only surgery I had ever had was getting my tonsils out when I was five," she laughed, "so I really didn't know what to expect."
Hansen recalled feeling homesick when she first arrived at Brown, but Graves made her feel comfortable. "I just sort of glommed onto her," she said. "And she didn't reject me. She let me kind of tag along after her."
They remained friends throughout college, and over 20 years later found themselves on the phone discussing the upcoming procedure. After months of waiting, it was the day before both would undergo surgery, one in Colorado and the other in North Carolina. "We were kind of at this point, you know, 'I'll really believe it when I'm lying there being wheeled into the operating room,'" Hansen said. "The night before the surgery, we both had really high hopes ... but there's always a lot of uncertainty."
Contrary to popular belief, Graves says, a kidney transplant is not a complete cure. She takes about 35 pills a day to keep her body from rejecting the foreign organ and must take these for the rest of her life. However, she is thrilled to be off dialysis and grateful to Hansen, though she and her sister no longer speak.
Hansen recovered quickly and was feeling "quite good" within a week after the surgery. This weekend she traveled to Toledo, Ohio for a reunion of donors and recipients in the Alliance for Paired Donation. The experience of donating a kidney expanded her compassion and awareness of the need for organ donation, she said. Both women pointed to the unnecessary deaths due to a lack of available transplant kidneys, which number over 10 people per day, according to the United Network for Organ Sharing.
Both friends affirmed that they have grown closer in the past months. Although they have not seen each other in person since the surgery, Graves said she hopes to visit Hansen soon.
"Forget my biological sister," she said. "Martha's my sister, because she stepped up to the plate."