When Kathy Allen of St. Peter needed a kidney, her son's close friend, Greg Enz, volunteered to donate.
The transplant and donation happened as planned in March at the Mayo Clinic in Rochester. Only Allen didn't receive Enz's kidney.
Allen was incompatible for a donation from Enz because of mismatched antibody levels. She received a transplant from a compatible stranger, and Enz, a St. Peter native, donated to someone else on her behalf.
The two were part of a 10-person paired-donation chain, during which five people received transplants. Four people, including Allen, received kidneys March 25, and a fifth person received an organ about two weeks later.
“It was just amazing because I thought I would be waiting forever,” Allen said. “It's just so wonderful to think about the future, because for the last few years it's been, 'I don't know if I have a future.'"
Paired donations are becoming more common nationwide as providers seek solutions to the growing need for organs. There were 549 paired donations in 2014, including 33 in Minnesota, according to the United Network for Organ Sharing. That's up from 281 in 2009 and 34 in 2004.
A paired donation involves two mismatched donor-recipient pairs. The donors, typically family members or friends, swap recipients, giving the kidney to the compatible person.
The paired donation can become a chain when an altruistic donor provides the initial organ. The chain continues through a friends or family members of the recipients, whose kidney are donated to others in need.
Chains can continue for months and across dozens of hospitals and states. The record chain, completed last month, included 34 transplants in 26 hospitals over three months.
Mayo Clinic has performed about 175 paired exchanges, said Dr. Mikel Prieto, who oversees the organization's paired-donation program and performed Allen's transplant. About 20 to 25 percent of its kidney transplants come from paired donors, he said.
"The initial feeling is strange, but when people learn about the project, they actually feel good because their donation helps multiple people," he said, noting recipients often meet their donors after transplants.
Mayo Clinic initially performed paired exchanges only for loved ones without other options, Prieto said. It opened up the program after a couple of years.
Prieto said in some cases it's better for a person to receive a kidney from someone who is unrelated. A 65-year-old father, for example, may be more compatible with someone his age rather than his 25-year-old son, he said.
"We find that a lot of couples are willing to help as long as they are getting a kidney that is as good as they were going to get," he said.
Allen, a longtime St. Peter resident, was diagnosed with polycystic kidney disease more than 25 years ago and lost kidney function about 16 years ago. Her son Ethan Allen donated a kidney to her in 1999.
That kidney began to fail about a year and a half ago. In November, Allen had surgery to prepare for dialysis.
In stepped Enz.
He and Ethan had been close friends since seventh grade. They played football together at St. Peter High School and served as the best man in each other's weddings.
Enz inquired about donating years ago when Kathy Allen's sister was in need of a kidney, but she found a match before he could proceed.
“Ethan being so special to me, (Kathy) just becomes special as well,” Enz said. “Anybody who gets to know that family, they realize quickly how special they are.”
Kathy Allen said she was “stunned” by Enz's decision. “It's like someone gives you $500,000; it's just too much,” she said. “You have to work through all that and just be very grateful.”
Ethan Allen said it's humbling someone outside their family would provide such a gift.
“It's generous on a whole other level,” he said. “At the same time, it's really consistent with his character. He's just a very selfless person and really thinks of other people. That's part of who he is and what he is motivated to do.”
Allen's body accepted the kidney, and she spent several days recovering at the hospital, where she met her biological donor. She stayed at the Gift of Life Transplant House in Rochester after the transplant, aided by three friends who volunteered as caretakers.
Allen is back in St. Peter and said she is feeling well and more mobile than before. At 66, she said there's a good chance she won't need another transplant.
"It's just kind of a new life for me," she said.
Enz spent April recovering at his home in Brookings, South Dakota and returned to work Monday. He said the transplant added another dimension to his friendship with Ethan Allen.
"I didn't think we could get any tighter as far as our friendship," he said. "I guess we just have a new kind of bond."