"I'm not losing nothing," Honica Brittman said this week, sitting in a blue and white hospital gown before surgery in which she would give, for free, the initial kidney in a chain of five kidney transplants at the New York-Presbyterian Hospital/Columbia University Medical Center.

"To actually help somebody live a little bit, a lot longer, that's an awesome thing," she said.

Brittman, who decided to be part of the swap after learning she could not donate to a family friend because of incompatibility, represents what experts say is a critical and growing number of "altruistic" or "non-directed" donors, people willing to donate to anyone in need as long as their blood type, antigens and other factors are compatible.

The health dangers for kidney donors is believed to be low. The risk of death from the surgery is 1 in 1,700, according to the National Kidney Foundation, and life expectancy is said to be unchanged with one kidney.

High blood pressure is a possible side effect, and critics point out there is no systemic collection of national data on the risks associated with living kidney donations.

Experts say donors such as Brittman are key to helping the over 90,000 people awaiting a kidney transplant in the United States, according to the U.S. Organ Procurement and Transplantation Network.

As in Brittman's case, donors can enable a chain of kidney exchanges that increases the number of people who can benefit from live kidney transplants, which typically last longer than cadaver kidneys.

The series of operation on Wednesday and Thursday, which required 10 separate surgical teams and weeks of coordination, was made up of a series of swaps within a group of men and women between the ages of 23 and 68 and with compatible blood types, all motivated by a mix of compassion and commitment to their loved ones.

The chain started with Brittman, who donated a kidney to a 39-year-old television producer whose fiancée and partner of more than 10 years donated to a businessman from upstate New York.

In turn, the businessman's son, a college-age student who felt that for being healthy and the youngest of four sons, he should step up on behalf of his father and donate one of his kidneys to another young man, a 23-year-old originally from Haiti.

His father then donated to a retired teacher from New Jersey.

"CAN'T WAIT TO MEET THEM"

The operations took place in neighboring rooms with doctors simply walking from one room to another to deliver the small, plump vital organ from the donor to the recipient.

The chain that Brittman made possible ended on Thursday when a woman, the wife of the retired teacher, donated her kidney to another woman who had been waiting four years for a transplant.

"All this stems from the fact that this young woman ... wanted to donate a kidney purely altruistically without knowing any of the recipients," said Lloyd Ratner, a surgeon and director of renal and pancreatic transplantation at the hospital.

Brittman, by giving the first kidney, prevented any pair in the chain from having to donate a kidney before receiving one.

While there is no conclusive national data on the number of donors like Brittman, experts estimate they have increased to between 100 and 200 a year, up from just dozens a few years ago.

"After every chain that gets some publicity, there's a flood of potential donors contacting kidney exchange networks and individual transplant centers," Alvin Roth, an economics professor at the Harvard Business School said.

The chain was also made possible by the decision of another pair in the group to be part of it.

Adam Abernathy, the television producer, and his fiancée Dave Ferguson, 43, could have done a simple transplant between them because Ferguson's blood type made him a universal donor.

But they decided to be part of a chain when it was proposed by the hospital that Ferguson donate his kidney to a man whose blood type had made him a harder match for a donor, A. Jamal, the businessman and father of four.

"We realized if we were in somebody else's shoes, we'd want someone to do the same," Ferguson said.

Most of the group said they plan to meet their donors after recovering from the operation.

"I can't wait to meet them," Brittman said.

(Editing by Philip Barbara)

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