This Woman's Brave Decision to Voluntarily Donate a Kidney Saved 7 Lives
If you met Tonja Downey, you might assume her decision to donate one of her kidneys came about because of her job.
As a nurse, the 47-year-old has worked with patients with kidney failure since 1996, first on the kidney transplant floor of a hospital, now as an administrator at an outpatient dialysis clinic near her home in Clarinda, IA. Three days a week, patients arrive for a four-hour session tethered to a dialysis machine that filters their blood of toxins—the job their kidneys can’t do effectively anymore. It keeps them alive, says Downey, but keeping up with the treatment is “like a part-time job.”
Really, though, her desire to donate a kidney was inspired by her dad, Jack Downey. He was in his late 40s when his kidneys began to fail as a side effect of diabetes, and his illness had forced him to take disability leave from his job driving a forklift at a transmission factory. For two and a half years, he languished on the wait list for a kidney transplant.
Right before Tonja got married in 1998, Jack received a donor kidney from someone who’d passed away. With the extra 19 years that the transplant surgery bought him, he walked his oldest daughter down the aisle, pursued his dream of becoming a long-haul truck driver, traveled the United States, saw Tonja’s two younger brothers get married, and played with his 10 grandchildren. “Those are things he might not have experienced had he not had a transplant,” says Tonja.
In 2017, her dad’s health had started declining again, and Tonja began thinking seriously about donating a kidney in his honor. Around that time, she heard about a man from her hometown who needed a kidney transplant—a 47-year-old engineer and father named Chris Hitt. Although about a third of kidney donations come from live donors, a genetic condition prevented most of his family members from donating to him, and a cousin who’d stepped up wasn’t a match. Tonja thought, How cool would it be for me to do this?
Committing to Organ Donation
Tonja made an appointment with Nebraska Medicine in Omaha—the hospital where she’d previously worked on the transplant floor and where her dad had received his own kidney transplant years earlier. But before she got very far into the process, her dad died, at age 71. The doctors at Nebraska Medicine pressed pause to make sure that this big life decision wasn’t colored by grief. A few months went by before Tonja got the ball rolling again. Then she got more bad news: She wasn't a match for Hitt.
The doctors had a suggestion: Since her purpose was to donate in honor of her dad, would she be willing to start a transplant chain?
“Kidney transplantation has a supply and demand problem,” explains Jayme Locke, M.D., director of the Comprehensive Transplant Institute at the University of Alabama at Birmingham School of Medicine. “More than 100,000 people are in need of a kidney transplant. People want to donate to a particular individual, so we think about, How do we help this person get transplanted?”
The solution has been kidney transplant chains. When a friend or relative wants to donate but aren’t a match because of blood group and tissue incompatibilities, doctors match them with another compatible recipient—and the people who wanted to help that person donate to another unknown recipient. It creates a kind of round robin that results in transplants for multiple people. Though donors don’t know who they’re giving to, they know that the person they originally intended to help will receive a kidney in the end. When that happens, Dr. Locke says the change in a sick patient is immediate: “You watch their color change. You watch them become brighter, more full of life. They will tell you that they feel amazing. They feel like a completely new person. It’s remarkable to watch.”
In this transplant chain, Tonja was the first person to agree to give. She remembers explaining the plan to her three sons, then ages 14, 12, and 8. Her 12-year-old asked, “What do you get for doing this?” Tonja replied, “Well, I get to feel good. I get to know that I helped somebody.” He said, “I think you should get at least $500.”
Tonja laughs at the memory now, but acknowledges that when she was younger, she wasn’t thinking as much about giving back. Time and perspective have impelled her to action, as she’s recognized the impact she could have on another family with one demanding but doable act of service. “I know what I gained because someone said yes,” she says.
The Chain Effect
The surgery, right before Thanksgiving in 2018, went smoothly. After three and a half weeks of recovery, Tonja was back at work at the dialysis center. She never knew who’d received her kidney until spring 2019, when she received a letter from a man explaining that “he received my kidney and it made a huge difference in his life. He was a younger person with three kids, similar to my dad, somebody who still wanted to raise his family and had all these health challenges that prevented him from doing everything he wanted to do.”
In May 2020, Tonja finally met him in person—plus all the other donors and recipients in the transplant chain—at a reception arranged by Nebraska Medicine. The reveal party happened to be the week after the first anniversary of the death of Jack Downey, Tonja’s father. “In a way it was like the stars all aligned. Like I wanted to do that whole thing to honor him, and we celebrated it,” she says.
In all, seven people suffering from kidney failure were given the new organs they needed to extend their lives. One was Scott Smith, a 61-year-old nurse practitioner who’d been ill since 2014. His wife was another donor in the chain. Now he’s healthy enough that they can become missionaries for their church.
Reed Peters, 72, a recently retired anesthesiologist, received a transplant from a woman who hadn’t been a match for her 8-year-old nephew. He’s been taking culinary classes and playing with his two young grandkids.
Iva Bryant, 68, received a transplant after many years of kidney disease. Her daughter donated to someone else, putting Iva in the chain. “To watch my grandkids grow up was my main goal,” she says. “There was a chance I wouldn’t be able to, and now I will.”
Tonja Downey knows that Chris Hitt, the man that she had originally hoped to donate to, gets to play football with his 10-year-old son without getting winded post-transplant. That makes her think fondly of the extra years she had with her dad, Jack. “I think, How many times did he babysit for me? How many times did my car break down and he came and helped me? Just the simple things. Now my hope is that the person I donated to, that his family and his children get to experience a lot more of him.”
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