At 8:25 Thursday morning, Dr. Peter Schulam extracted a healthy kidney from a 60-year-old woman, slipped it into a bowl of sterile ice and wheeled it into the operating room next door. The donor, Nancy Seruto, a San Dimas mother, had never met the recipient, a 67-year-old retired flight attendant from Santa Ana.
Less than two hours later, Seruto's husband was on the same operating table at Ronald Reagan UCLA Medical Center. Another stranger, a 53-year-old Chatsworth mother of two, was giving him a kidney.
They were among 18 patients paired by surgeons as part of a rare transplant chain, built largely on trust.
Each link in the chain represents a paired donation in which a donor gives a kidney to a stranger, trusting that another stranger will donate a kidney to his or her loved one in return.
Such chains are difficult to build, because of the trust issues involved and medical complications. Donors and recipients must have compatible blood types and antibodies. Surgeons usually have to perform multiple transplants simultaneously in adjacent operating rooms, both to ensure that transplanted kidneys stay healthy and that donors do not get sick or back out, breaking the chain.
After Celia Contreras, 39, volunteered to donate her kidney to help a family friend as part of the UCLA chain, she said her husband pressured her not to, worried that their three children might one day need a kidney.
Contreras, an elementary school teacher, held her ground.
"I truly believe that what you put out there comes back to you," she said.
For would-be recipients, donor chains can shorten the wait for a transplant by years, experts say. As of this month, 82,061 people nationwide were waiting for a kidney; 16,416 of them in California, according to the United Network for Organ Sharing, based in Richmond, Va.
Network officials are developing a national registry that they plan to launch next year with five pilot sites, including UCLA. That could lead to an additional 1,000 to 2,000 kidney transplants annually, according to Dr. Bryan Becker, president of the New York-based National Kidney Foundation.
"It's a huge opportunity to expand the donor pool," said Dr. Jeffrey Veale, director of the UCLA Kidney Transplantation Exchange Program.
For now, donor pairs have to rely on smaller networks, including the National Kidney Registry in Babylon, N.Y., which two years ago started keeping a list of paired donors. UCLA surgeons used the registry to build the latest donor chain, their fifth and one of about a dozen the registry coordinated nationally this year, a spokesman said.
The chain started last year with Harry Damon, a firefighter in Grand Rapids, Mich.
Damon, 55, wanted to donate in memory of his 22-year-old son, who had died in a snowmobile crash. He contacted the registry looking to give his kidney to a young man.
Instead, he was matched with Sheila Whitney, 49, of Compton, a disabled teacher's aide with lupus who had been waiting on dialysis for more than six years.
"I thought, 'This is bound to be,' " Damon said.
He flew to Los Angeles for the chain's first transplant June 8.
The same day, Whitney's 27-year-old son, Reginal Griffin, donated to Keenan Cheung, 44, a USC housing manager and father of three from La Canada Flintridge. Cheung's wife, Jeanne, 43, who works at a Burbank production company, donated to Sonia Valencia, 29, a resource teacher in Commerce who is friends with Contreras.
Surgeons then had to coordinate with the California Pacific Medical Center in San Francisco to match Contreras with Priscilla "Pia" Miller, 36, of Fresno, a disabled bank teller, flying Contreras' kidney to San Francisco for a transplant June 10.
Miller's roommate's brother, Anton Goodfriend, 25, of Springfield, Mo., an armored car driver, then flew to San Francisco in July to donate to Ross Bloom, 55, a real estate investor in Chatsworth. Bloom, who was incompatible with 97% of donors on most waiting lists, called the chain a miracle.
On Thursday, his wife of 34 years, Fern Bloom, donated to Joseph Seruto, 64, a business owner from San Dimas. Bloom had never been operated on before, but was giddy as she waited in a gown in the preoperative room. She called the chain "bashert," Yiddish for "meant to be."
Down the hall, Seruto's wife, Nancy, a bookkeeper, was preparing to donate to retired flight attendant Donna Morrison.
The Serutos did not have to join the chain -- they were compatible with each other. The couple, who have been married 37 years and have two grown children, chose to participate after their doctor suggested they could help Morrison, a former globe-trotting flight attendant who had been on dialysis for several years.
Late Thursday, Morrison's fellow Continental flight attendant, Ellen Harmetz, 61, of West Los Angeles, donated to Phyllis Thompson, 54, of Simi Valley, a stay-at-home mom.
Thompson's husband, Gregory, 56, a project manager at an architectural firm, is scheduled to make the last donation in the chain Tuesday.