Joy Hindle cried when she found out she couldn't give one of her kidneys to her twin brother.
Then doctors gave the Bel Air woman another option: a kidney exchange, in which she would donate her kidney to a patient who needed one, and her diabetic brother would get one from another willing donor.
Hindle and brother Paul McSorley were two of six participants in a triple kidney transplant performed last month by doctors at the University of Maryland Medical Center. She gave her kidney to a stranger; he got a kidney from a stranger.
"My main concern was my brother's health," Hindle, 55, said Friday. "I would have done anything."
Multipatient swaps made up a small percentage of the more than 13,000 kidney transplants performed in the United States last year.
But with the creation of a national database to link the 90,000 patients waiting for kidneys with compatible donors, some health care officials expect the number to increase dramatically.
"We think it is the future," said Matthew Cooper, director of kidney transplantation at the medical center in Baltimore. "This is going to help us get so many more transplants done."
Cooper and others say the multipatient swaps expand the donor pool, which they expect will increase the number of people who get the kidneys they need.
Nationwide, 421 patients received kidneys through such exchanges last year, up from 268 the year before.
Some advocates believe the database, which links 77 medical institutions and transplant programs across the country, could boost the number of recipients to 2,000 or more.
"There is a huge organ shortage," said Joel Newman, a spokesman for the United Network for Organ Sharing, which operates the database for the federal Department of Health and Human Services. "We're allowing transplants to take place that wouldn't otherwise."
The first swap between patients and donors who were matched through the database was performed in December.
So-called kidney paired donor transplants remain beyond the reach of many medical institutions. The swap at the University of Maryland Medical Center on June 15 took 200 medical staff, including eight transplant surgeons and 12 anesthesiologists.
Each surgery, in which the kidneys were removed through a single incision in each patient's navel, took two to 21/2 hours to perform.
All six patients met for the first time Friday at the medical center.
After Hindle learned she wasn't a match for her brother, she said, she jumped at the chance to join a swap.
McSorley lost one of his kidneys at age 10. He was playing ball in a Baltimore alley and ran into a '56 Chevy; one of his ribs sliced the organ in half.
He said he lived a healthy life with one working kidney until he was diagnosed with diabetes. He said he didn't always follow his doctor's orders; when his kidney function dropped to 13 percent, he went on dialysis.
But McSorley was filled with gratitude Friday when he met 28-year-old Jesse Epperley.
Epperley had volunteered to donate to Mae Opie, a retired teacher who went to one of the churches he attends. Opie, 73, suffered from polycystic kidney disease, which had enlarged her kidneys to the size of basketballs.
But Epperley learned they were incompatible. Told of the possibility that Opie could benefit from an exchange, he said, he searched his soul and talked to God.
"I have a young son and wondered if I would be doing the right thing," Epperley said. "What if he needed a kidney one day?"
Epperley gave a kidney to McSorley. Opie received a kidney from Karen Becker.
Becker had wanted to donate a kidney to her husband. John Becker, 54, who became so sick last year he couldn't get out of bed.
He was diagnosed with polycystic kidney disease and wanted a transplant to avoid having to go on dialysis.
Hindle donated her kidney to Becker. Hindle said she glances down at her navel every day, and marvels that there is no scar.
There were hugs and misty eyes as the six met on Friday.
Karen Becker, 54, had seen Opie in the hospital before the surgery and wondered if she was the one who would get her kidney. Hindle and Epperley found out they both attended the same home church, leaving them both to declare divine intervention.
McSorley said he has found a friend for life in Epperley.
"I am forever grateful to him," McSorley said.
Epperley said the meeting Friday was only a beginning.
"We are six people who have had a miracle done to us, and our lives changed and we will forever have a bond."