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Portrait of compassion: Why does a patient donate his kidney to a stranger?

March 14, 2017

Tim Horner decided he would donate his kidney to a stranger, to start a phenomenon known as a kidney chain.

Tim Horner, who teaches in the Center for Peace and Justice at Villanova, was driving one night through South Carolina, listening to an NPR report about kidney donation and how many people need kidneys.

“I looked down at my stomach,” he recalled. “I’ve got an extra kidney. How could I ever not do this?”

At that moment, he decided he would donate his kidney to a stranger, to start a phenomenon known as a kidney chain, that would trigger still more donations.

He had only one fear.

“I looked at my wife sleeping next to me,” he said, “and knew she’s just going to go nuts.”

Horner, 51, teaches classes in genocide and social justice. He went to Rwanda in 2007, saw the impact of genocide up close, and it changed him forever.

“This donation is part of that change in my own sensibilities about who I am as a human being,” he explained last week. “What I’m supposed to do while I’m here? How do I participate in the human family?”

His wife, Julie DeWerth, pastor at Good Shepherd Lutheran Church in King of Prussia, has been incredibly supportive, and so have his four children.

“He comes up with a lot of crazy ideas,” said his wife, like the time he rode a scooter to British Columbia to protest a pipeline through Native American land. “I think that was more dangerous than donating a kidney.”

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Some facts:

The humble kidneys filter waste from our blood, control the body’s fluid levels, and regulate our salt and other key chemicals. Those with diabetes, hypertension, and obesity _ often the poor and disadvantaged _ are especially at risk of developing kidney disease.

26 million Americans have kidney disease, which kills more than 90,000 Americans a year — more than breast and prostate cancer combined.

More than 400,000 are on dialysis.

About 90,000 are waiting for kidney transplants; nearly 5,000 die waiting each year.

The number of kidney transplants has stayed flat since 2007, averaging about 16,800. About one-third were from live donors.

The National Kidney Registry says it started its first chain on Valentine’s Day 2008 and has now done 415 chains, leading to 2056 transplants, saving an estimated $1 billion in dialysis payments.


The way a chain works is simple. In this case, there was a person in Rochester, N.Y. in need of a kidney. That person had a partner willing to donate, but the partner’s kidney wasn’t compatible. When Tim agreed to be what is called a nondirected donor, the registry determined that the person in Rochester was compatible with Tim and most in need. So Tim’s kidney went there. That recipient’s partner in Rochester agreed to donate a kidney to someone else in need, with whom he was compatible, in this case a recipient in St. Louis. If each recipient has a partner, the chain continues.

One chain in 2012 led to 30 transplants over six weeks.

Temple did about 60 kidney transplants last year, five with living donors. It joined the National Kidney Registry last year to get involved in kidney chains, and to increase living donations, and to cut down on waiting times. Tim’s donation triggered the first chain starting at Temple.

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Tim and his wife returned from Israel a week before the surgery, so Tim decided to name his donated kidney Moishe, and he asked his surgeon, Antonio Di Carlo, if he could make the scar look like a question mark.

“I’m all about questions,” Tim explained. Di Carlo could only make it look like a scar.

Tim donated his kidney Tuesday morning in a three-hour surgery.

Di Carlo came out to see Julie in the waiting room.

“It went well. He slept through it.,” Di Carlo said with a grin. “Looks like a nice kidney for somebody. It’s already on the flight.”

“Thank you so much,” Julie said. “Thanks for taking such good care of him and thanks for your humorous nature.”

“Anybody that has the audacity to go through this has to be an amazing person,” said the surgeon. “Some of us are afraid to give blood.”

Di Carlo said people who donate a kidney on average live longer than those who don’t. Not because kidney donation extends life, but because people who are able to donate tend to be healthier, and continue to live well with one kidney.

Tim thought he’d go home the next day. But it wasn’t until the second day, Thursday, that he felt like talking.

“Getting up the first time was a surreal amount of pain,” Tim said.

“I’ll be honest,” he added, “a couple times I wondered, `Oh, man.’ But only a few times. And fleeting.

“Am I glad I did it? Absolutely,” he added. “For somebody out there with a new kidney, it’s Christmas morning.”

Di Carlo came in with his team of residents and students.

“You look like a new person today,” Di Carlo said.

“I was filling these urinals up like I was a bottling plant,” Tim said.

The doctor told Tim to take it easy at home.

“Your other kidney is waking up,” said Di Carlo, “asking where did Moishe go?”

Moishe, by the way, was doing spectacularly well in his new home, the doctor said.

Tim did not want to know the length of his chain. He didn’t want that to be the measure of success. There are so many factors involved, and he has no control.

He went home that afternoon with a simple thought.

“It feels good to do good things.”

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Michael Vitez, winner of the 1997 Pulitzer Prize for Explanatory Journalism at The Philadelphia Inquirer, is the director of narrative medicine at the Lewis Katz School of Medicine at Temple University.