Laura and Raymond Lopez just were getting into bed when their daughter phoned, saying only that she was coming over to tell them something.
"I didn't want to tell y'all this until I knew for sure," she began. "But I'm going to donate my kidney."
Laura felt relieved. Of course — she'd always known her sensitive middle child planned to be an organ donor. It said so on her driver's license.
"That's wonderful!" she said, hugging her daughter.
Sensing that her mom didn't quite understand, Jennifer pulled back. Her brown eyes locked with her mother's.
"Mama, I'm going to do it now," she said excitedly.
A few days later, Yi Wang received the call. She was at an Austin clinic with her 2-year-old son for his routine kidney dialysis when a nurse summoned her into a break room and handed her the phone.
"Michael has a kidney," Yi heard a familiar voice on the other end say.
"What? Is this for real? Are you sure?" Yi asked excitedly, tears starting to stream down her cheeks.
"Yes, yes," said Anita Lopez-Saldana, a transplant coordinator at San Antonio's University Health System. "But it will be a while until we're ready," she said.
Yi, who's originally from Taiwan and often questions her English abilities, didn't understand. A cadaver kidney, she knew, only can be preserved out of the body for two to three days. Didn't her son need to be in San Antonio right away to prepare for an immediate transplant?
"Yi, this isn't a cadaver. This is a 26-year-old young woman who wants to donate — a stranger," she said.
Yi felt a mixture of elation and confusion. Her son, Michael, born two months premature with diseased kidneys, finally would receive a new organ after two years spent fighting sickness and infection and an excruciating year on the transplant waiting list.
No more dialysis. No more eating through a tube.
But other thoughts raced through Yi's head: A stranger? Why did she want to do this? What does she want in return?
An unusual offer.
In its more than three decades of performing kidney transplants, the University Health System never had someone call out of the blue, offer up an organ to a total stranger and then follow up on the proposition. Until Jennifer.
The Methodist Healthcare System's Texas Transplant Institute gets calls from strangers wanting to donate kidneys, but none ever has resulted in an actual transplant, spokeswoman Palmira Arellano said.
That's mainly because people back out once they learn of the extensive tests involved — including blood draws, psychological screenings, tissue typings, an electrocardiogram, a 24-hour urine catch and a colonoscopy, just to name a few.
Acquaintances, friends and family often donate to those in need. Nationally, anonymous living donors account for a slim but growing number of donations, according to Annie Moore, spokeswoman for the United Network of Organ Sharing, a nonprofit organization that administers the nation's organ procurement and transplantation network.
Since UNOS began collecting data on such donations in 1988, there have been 241 anonymous living kidney donor transplants performed, with 81 performed last year, Moore said.
On Thursday afternoon, Jennifer became the first such donor in the San Antonio area.
During an almost four-hour long dual procedure, Dr. Alejandro Mejia took Jennifer's kidney from her body and flushed it with cold fluid. It then was carried in a sterile basin next door where a sedated Michael was waiting. His surgeons then made an incision at his belly and carefully inserted the new kidney into his abdominal cavity.
Although the surgery was considered a success, the next couple of months are critical. Early rejection of the kidney is a possibility, and Michael is receiving anti-rejection medications to try to prevent complications.
Even though Jennifer's kidney was removed laparoscopically, she'll be in considerable pain for a few days, doctors said. Her hospital stay could be several days and she will be asked to avoid heavy lifting and other strenuous activities for one to two months.
Doctors and medical ethicists have debated the idea of living organ donation — and they are not without risk. At least 17 living kidney donors have died after surgery, six within the first week, according to UNOS.
A compassionate life.
After she was shown to her hospital room Wednesday, Jennifer set up the few things she'd brought along. She placed a framed photograph of her two young nephews, ages 1 and 2, on a corner shelf. On her bedside table, she stacked two books: "East of Eden" by John Steinbeck and her longtime favorite, "Start Where You Are: A Guide to Compassionate Living," by Buddhist nun Pema Chodron.
According to those who know her best, Jennifer is herself a living guide to the art of compassionate life. As a child, she toted around a protective mesh cage filled with assorted bugs and creatures. She graduated from Smithson Valley High School with honors and the only "F" she ever received came after she refused to dissect a frog because she was saddened by the very thought of it.
Even when she was very young, people noticed that Jennifer was different from many of her peers. Her grandfather called her "an angel on earth."
Now a theology student at Texas State University, Jennifer manages a lingerie store while balancing studying, church activities, a boyfriend and her constant athletic training for marathons and triathlons. Also a vegetarian, Jennifer expects to make an Austin marathon in February.
Her decision to donate a kidney stemmed from her relationship with a longtime friend, Al Ramos, who's in his 50s and has diabetes. A few years ago, he was in dire need of a kidney transplant. But now, his illness has so ravaged his body that he no longer is a viable recipient.
Watching her friend go through so much — suffering a recent stroke, losing a vast amount of weight — Jennifer felt helpless. With the thought of trying to donate her kidney to him, she first got her blood tested to see if she they were a match. But when the test came back negative, she still felt called to continue with the process and donate her kidney to whoever needed it.
It was Michael who was highest on the waiting list and whose tissue types were similar enough to Jennifer's to match five of six primary categories. A child on dialysis, which can damage development, often can be listed as at particular high need.
"You get passionate about ending people's suffering," Jennifer said from her hospital bed before surgery. "I've been blessed with health and I've got this kidney so why not share it? I'm like, if someone needs it, by all means take mine."