THERE are a billion people on the Internet, and perhaps someone, somewhere, had a kidney to spare.
"19 yr. old daughter needs O kidney," Karol Franks typed, specifying the proper blood type.
Her eldest child, Jenna, had a rare defect that destroyed her kidneys. She had been undergoing dialysis for more than year, tethered to a machine three days a week, three hours a day, to filter toxins from her blood.
Exhausted after each session, Jenna usually retreated to her bedroom. "I'm fine," she would tell her mother before climbing the curving staircase of their spacious home.
Her daughter's youth was slipping away, Karol thought.
No friends or relatives were found to be acceptable matches for a transplant. Kidneys from cadavers are allocated primarily to those who have waited the longest, and Jenna was at least five years from the top of the regional transplant waiting list. Karol thought of getting an organ from one of her other children, but at 16, 14 and 9, they were deemed too young to donate.
With no alternatives, Karol last year turned to the Internet, though she couldn't imagine why someone would want to give a kidney to a stranger.
Money, guilt, salvation?
Karol continued typing: "Please consider donating a kidney so she can get off dialysis."
Her husband, Ed, was skeptical. He didn't place much hope in the Internet, full of scammers and kooks.
Disabled by a back injury, Ed was often resting in his room. Down the hall, Jenna was quiet in hers.
Karol remained alone downstairs at her computer.
"We are in Pasadena, CA. Thank you from a very grateful mom," she concluded and posted her message on the website www.livingdonorsonline.org. The return address: kidney email@example.com.
She said nothing about it to Jenna.
Being on dialysis is like someone hitting the "pause" button on your life, Jenna said.
She was 15 when doctors determined that her kidneys were failing, the result of pressure in her urinary system from an inability to sense when her bladder was full.
At first, Jenna refused to accept that she was sick, stashing her medicine in her dresser until the housekeeper found it and told her mother. As Jenna grew more lethargic, her defiance waned.
At the dialysis clinic, Jenna was always the youngest patient. Flopped in a padded recliner, she usually placed a pillow over her face and fell asleep.
All around her were patients who had been on dialysis for years. That was her future, she imagined.
Karol, now 52, urged her to meet other teenage kidney patients. Jenna didn't see the point.
"That is my way of dealing with it -- not dealing with it," Jenna said.
Karol gave up trying to talk to her daughter about a transplant.
In an office next to the dining room, she searched the Internet for a donor, advice or just somebody to talk to.
The statistics were depressing: more than 60,000 people in the U.S. waiting for kidney transplants. The list grows by nearly 5,000 patients a year.
Fewer than 17,000 kidneys are transplanted annually. Most come from accident and stroke victims or living relatives.
About 1,500 a year come from other unrelated donors, mostly family friends.
A tiny portion -- no one knows how many -- come from strangers, increasingly found on the Internet.
Many doctors feel queasy about such donors. Selling organs is illegal in the United States, and they worry that patients and families will buy organs from people desperate to sell -- especially from abroad -- or accept them from crackpots desperate to give.
In recent years, it has become easier to find donors through websites set up for people looking for organs.
Once a deal is struck, it is not uncommon for people to pose as old friends to avoid raising suspicions from the hospital.
Karol asked herself: Was she willing to lie? Would she pay for an organ? What would she be willing to do to persuade someone to give away a kidney?
Subject: i can donate
It can be some dificulties but i can donate to your daughter one of my kidneys, i'm 44 o+ good health, living in mexico
The e-mails -- some in faulty English -- began trickling in the day after Karol posted her plea.
Subject: We need money to cure my kid $ 30 000! I am ready to become a kidney donor.
I will send my kidney! Kidney on sale! ... My age is 22, weight -- 68 kg., height 175. Absolutely healthy. I live in Ukraine.
Subject: POTENTIAL DONOR AVAILABLE
Hi! I am 28 years old, a single mother of an 7 year old boy named Josh.... We are called Jesus Christians. We try to follow the teachings of Jesus Christ and practice these teachings in our everyday lives, which is why I am writing to you now.
Karol pondered each message, forwarding some to her husband. Ed, now 54, had a doctorate in public policy and had been a financial analyst -- the family pragmatist.
He knew about hope and disappointment. In the seven years since injuring his back in a skiing accident, he had seen dozens of doctors and undergone four surgeries to relieve the constant pain. Nothing worked.