Nicki Coulter of Bloomfield started the domino effect. She donated a kidney simply because she thought it was the right thing to do.
Coulter, 40, had signed up as an organ donor in case of her accidental death. She thought it was important to make the gesture while living, she said.
So she Googled "kidney donation center," and that led her to University of Kentucky HealthCare.
On Wednesday, Coulter got to meet the domino-effect results of her generosity: Three of the four people her donation helped to get transplants got together at a UK HealthCare event.
As Coulter started to speak at the news conference, tears glazed her eyes.
"My parents taught me that giving was something that everybody needed to do," she said. "Knowing that I made a difference in somebody's life means a lot."
Coulter, who donated a kidney June 4, almost immediately returned to robust good health. She has no regrets.
UK HealthCare, which does 80 to 90 kidney transplants a year, has a waiting list of nearly 400. The hospital has performed kidney transplants since 1964. The donor-chain surgeries for this transplant series were performed in-house over the course of two days with staff from the UK Transplant Center and the UK Albert B. Chandler Hospital.
The kidney donor chain is one way to address the large number of people who need kidneys and the difficulty of finding an appropriate match, because it allows waiting patients with relatives and friends who are willing to donate a kidney on their behalf to get a kidney from someone else.
Other transplant centers, including Johns Hopkins, also use the method.
The chain began with Coulter, whose kidney went to Ted Burch of New Albany.
Vanessa Burch, Ted's wife, donated a kidney to John Tarter. Tarter's significant other, Susan Gibson, donated a kidney to Carolyn Dye. Pat Dye, Carolyn Dye's sister-in-law, donated a kidney to Garold Robinson, who was the highest match on the UK transplant waiting list.
The families affected stretch from Richmond to Pikeville and even across state lines into Indiana.
Carolyn Dye, a former school teacher and a former mayor of Coal Run Village in Pike County, said the transplant "gave me my life back."
She hopes to be back in shape enough to walk, possibly as much as a mile, in an upcoming Kidney Walk on Oct. 11.
Pat Dye, her sister-in-law, who lives in Richmond, said she wanted Carolyn to live long enough to experience the joy of grandchildren.
Michael Karpf, UK's executive vice president for health affairs, described the kidney donor chain as "a milestone."
"There aren't very many transplant programs in the country that can do transplant programs like this," he said.
Dr. Stephen Strup, chief of the division of urological surgery, said the kidney donor chain "brings in a level of trust that is a uniquely human thing. The reward ... is to see healthy people, and tell who gave and who received."