It was a no-brainer to Rusty Hiler that he would donate a kidney to a stranger so his dad, Benny, could also receive a kidney through a life-changing operation.
His wife and mother, however, took some convincing.
"He's just 34, we've got a young daughter, what if he gets diabetes later on, what if his other kidney fails ...," said his wife, Rachel Hiler, rattling off a long list of worries she has as her husband is about to have surgery.
"It's kind of a double whammy as a mother and a wife," said Monica Hiler, who is mom to Rusty and wife to Benny. But, she said, " Forget that he's my son. It takes a very special person to do this."
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And the act of generosity was made possible through a non-profit group, the Paired Donation Network. With a database of 220 pairs at 140 transplant hospitals, the group matched the Lexington father and son with an Ohio woman, Karen Stokes, and her friend, John Tatman. Both Benny Hiler and Stokes need kidney transplants because of complications from Type 1 diabetes. The four recently agreed to meet.
More often than not, family members are not a good match in kidney donations, said Jim Colston, director of public relations for the network. There are some 85,000 people on various transplants list waiting for a kidney, he said, and most are waiting for a kidney taken from a cadaver.
"There are a whole lot of people out there, just in this city, that need a kidney and don't get one," said Monica Hiler.
The network has matched 53 pairs so far, Colston said, adding that the number of people signing up for the service and the number of hospitals participating continues to grow.
"When we started in 2002, we had five hospitals and zero patients," he said.
It's not a straight line between signing up with the network and finding a match. This is the fourth time the Hiler family has been alerted to a potential match. The first three times didn't work out.
But Stokes and her friend and the Hilers have been cleared and will be going to surgery on Friday at University Hospital in Cincinnati. The donors will go into surgery at 7:30 a.m.
What Rachel Hiler calls the "magic hour," when the kidneys will be swapped, will begin at 9 a.m.
The extended Hiler clan, between 15 and 18 people, will be taking over a waiting room, packing a picnic lunch and waiting to hear what they expect to be good news by 3:30 p.m., when the operations are scheduled to be complete.
Dr. Steve Woodle, chief of transplant surgery at University Hospital, said the procedure should last about three hours. Organ recipients typically go home after about two days, and the donors are discharged after about five days. Woodle said the prognosis for all four patients is good.
While research has set aside some of the fears of Rachel Hiler, who works for the Herald-Leader, she hasn't stopped completely fretting. But in her heart, she knows her husband is doing the right thing. They've both watched his father suffer through dialysis and frequent infections.
The 58-year-old who once loved to play golf and was a competitive softball player, is limited to the house most days. He will never completely regain his once robust health because of a brittle-bone disease that developed related to his condition. It will probably keep him off the links forever.
But his son is hoping that the transplant "will get him feeling better so he can get out of the house, do some traveling."
Rusty Hiler, himself a golfer, won't be able to play for the six to 10 weeks it will take to fully recover. But, he said, that's nothing if it gives the man he refers to as a "top-notch" dad a measure of comfort.
"That's not at all a sacrifice for what he's done for me."