Spouses Robin Gilmartin and Diane Mack, of West Hartford, don't consider themselves to be heroes. Since they both decided to donate a kidney to a complete stranger, many others would disagree.

In 2015, Gilmartin and Mack looked into kidney donation after being inspired by a story in the Hartford Courant. "We thought it would be a wonderful thing to help someone who needed an organ," explained Mack.

The couple contacted Yale New Haven Transplantation Center (YNHTC) and spoke to Joyce Albert, RN, senior clinical transplant coordinator, who explained the evaluation process for living kidney donation.

Mack donated one of her kidneys in November of 2015 and Gilmartin patiently waited for her turn. Little did she know at this time that she would take part in a record-breaking kidney transplant paired exchange at YNHTC.

"When Ms. Gilmartin was ready to donate, one strategy would have been to have her donate to the first person at the top of the transplant list," explained Peter Yoo, MD, transplant surgeon. "One transplant, a life saved, it would have been an extraordinary act of kindness and altruism."

But Dr. Yoo met with transplant coordinators Albert and Grace Regala, RN, who poured over patient files to determine what other patients they could help. They started seeing connections for a four-way swap, then five-, then six. Eventually, they laid out the nine-patient paired kidney transplant exchange that began with Gilmartin's donor surgery on May 9.

Gilmartin's kidney would go to a woman in Ansonia, who was born with polycystic kidney disease (PKD), and managed her disease for years, but in 2015, it became apparent that she would need a kidney transplant. The woman's sister-in-law, of Laconia, NH, came forward as a possible donor. Although they were compatible, they agreed to participate in an exchange to maximize the donation. Through the exchange, the donor from New Hampshire was then matched with a man from Bethel, CT.

"Through this paired exchange, we were able to overcome some insurmountable hurdles that would not have been easily resolved without the advent of paired exchange," said Dr. Yoo.

According to the Centers for Disease Control and Prevention, more than 10 percent of American adults have chronic kidney disease. About 600,000 of them are on dialysis and 100,000 are on the kidney transplant waiting list. Yet only 16,000 transplants are done each year. On average, over 3,000 new patients are added to the kidney waiting list each month or one every 14 minutes.

"These donors are heroes, in the deepest sense of the word," said David C. Mulligan, MD, director of YNHTC. "To make this sacrifice for someone they don't even know is extraordinary."

For more information on the YNHTC and the Center for Living Organ Donors, visit the Yale New Haven Hospital Transplantation webpage.