An instant bond of friendship formed between Lori Christian and Marie Molin when they met through their children eight years ago. Molin taught Christian's youngest child in preschool and kindergarten, and the two women had one of those small-world ties where other family members had known each other for years.
But as tight as they had grown, Christian and Molin are even more connected now. Last week, Molin donated one of her kidneys to Christian, who was quietly dying from a degenerative kidney disease.
"I don't know how I can repay her," Christian, 47, said from her bed at Duke Hospital. "The fact is, this will give me a quality of life I never thought I could have."
The act of generosity, while not rare, is uncommon, given the need for kidneys and other organs. And among African-Americans, the need is even more acute. Because kidney disease is three times more prevalent among blacks than whites -- a result, often, of higher rates of contributing causes such as diabetes and hypertension -- the demand is especially high for organs from live donors, as well as victims of tragedy.
African-Americans represent 13 percent of the U.S. population, but comprise 23 percent of people waiting on kidney donor lists, according to the U.S. Department of Health and Human Services.
Christian was one of those on the waiting list, both at Duke and at nearby UNC Hospitals. Had it not been for Molin offering one of her organs, said Duke transplant surgeon Dr. Paul C. Kuo, Christian might have waited two to five years for a kidney. All the while, she'd have grown sicker and sicker -- and could have died.
"This is one of the most satisfying things we do as transplant surgeons," Kuo said. "It's a cure in the short term."
Few knew that Lori Christian was sick. She felt fine until returning from a vacation in Mexico six years ago with weird swelling in her legs. She initially chalked it up to a bug she might have picked up, but tests showed she had focal segmental glomerulosclerosis, a progressive kidney disease that affects the body's ability to process toxins.
It's the same disease that struck NBA star Alonzo Mourning in 2003. The cause is unknown.
For a while, Christian did well. She was able to continue playing tennis, plus keep up with her children's busy soccer and baseball schedules. But a regimen of steroids, which helps some people who have the disease, did little for her other than cause rapid weight gain. By last October, she was losing energy and would come home from work as a Wake District Court judge exhausted, unable to fully participate in her family's bustling activities.
"I would just come home and go to bed," she said. With her kidneys failing, she began dialysis in December. Her husband, Wayne, learned to operate a home dialysis machine -- a big, noisy contraption that required knocking a hole in their bedroom wall to reach water pipes for the filtration system. For four hours every other day, artificial filtration kept Christian alive.
She went on the kidney transplant list in February but told few people about her illness. Still, it was hard for friends not to notice that something was wrong.
"She is a very private person," Molin said, "and she didn't want anyone to know, but she told me she needed a kidney transplant. And I said, 'Lori, why didn't you tell me? I would give you a kidney.'"
Christian was reluctant to ask that of her friend and, in fact, hated even asking her family to be tested for blood and organ compatibility. But of six people who were screened, two were matches, including Molin and Christian's sister-in-law. Molin was insistent.
"I knew I was going to do this," Molin said. Since their first meeting at Sterling Montessori Academy in Morrisville, where Molin taught Christian's son, Justin, the two women had become fast friends. Molin's son Allan became close to Justin, so the women carpooled each other's children, got together for dinner, celebrated important milestones. Molin, a single mother, knew how much Christian meant to her family.
"I wanted to do this because Lori has two children, and so do I," Molin said, who has an older son in college. "I do not want them to have to grow up without her. Her children and her husband are her life. I'm constantly telling my children to help their friends out, and I felt like if didn't help Lori, I'd be a hypocrite."
But much depended on how well Molin matched. Living kidney donation -- taking one of two organs from a living donor -- has come a long way since it was first tried more than 50 years ago. Now, donors and recipients don't have to be exact matches for tissue compatibility, because new drugs do a better job of keeping the recipient's body from rejecting the donated organ. In addition, advances in surgery have resulted in a quicker, less invasive procedure for donors.
Still, there are risks, and both Christian and Molin went through a battery of physical and psychological tests to assure doctors they were healthy enough to come through their respective surgeries. During one exam, cysts were discovered on Molin's ovaries. The transplant -- scheduled for August so that Molin could recover before returning to her kindergarten classroom -- was put on hold while other tests were run. Six weeks later, Molin was cleared.
The transplant occurred at Duke Hospital on Oct. 3. Molin went home the next day, and Christian was released Wednesday. Kuo, her transplant surgeon, said she is likely to get up to 15 years of health from the new kidney, perhaps more if she takes care of herself.
Mending, and eager to see each other, the two friends reunited this week for the first time since becoming co-owners of a kidney.
"This just puts life in perspective," Christian said. "I woke up last Friday thinking, I really do have a new kidney."
And with it, she says, she has a renewed appreciation for the gifts of love -- and of loved ones.