PINE RIVER, Minn. - Only two hours after making a new friend at a Nimrod bar, Kristin Day offered him her kidney.

Day, of Pine River, saw a fistula on the man's arm, a port used for administering dialysis. He experienced health issues that left him with damaged kidneys for the last two years. As a result, he needed dialysis every other day until he received a kidney transplant.

So Day offered him a kidney.

"It was just kind of crazy," Day said. "We were at Nimrod at a bar. That's just how it happened. We were in the right place at the right time."

With certainly no guarantee of a match, Day said she started doing health screenings, blood tests and donor meetings without telling her friend. She did break the news to him before all the matches were finally made. He responded cautiously, reminding her she had a family and obligations, but Day said she was never afraid, and actually was excited.

When she received the call that she was a blood match and cross match, she said she took two hours to calm down.

"I honestly had no fear about the surgery," Day said. "I felt well-informed. I felt so sure about my decision. I think that's why I didn't feel scared about it."

Almost six months to the day of meeting her friend, Day was wheeled into an operating room, where she made good on her offer to donate.

"It was something I felt I had to see through," Day said. "I felt like I was here to do this. I've never had that feeling before."

Day spent four days recovering at the hospital, and a few days in significant discomfort at home due to a bad reaction to pain medication. If not for that reaction, she said recovery would have been no big deal.

After the surgery, Day's sister posted photos of her journey on Facebook, calling her a lifesaver. At track and field day at Pine River-Backus Elementary School, people sought her out to hug her and called her a hero. She joked she didn't feel like a hero, but maybe she would if her family bought her a cake.

"It makes me feel goofy," Day said.

Organ transplants

Day might not feel like a hero, but donors like her save lives, or at least improve them. According to Mary-Beth Miller, living donor coordinator with Sanford Transplant in Fargo, the team that worked with Day, 21 people die every day waiting for an organ transplant, with another person added to a waiting list every 10 seconds. In the region of Minnesota, North Dakota and South Dakota alone, 3,400 people are waiting for organ transplants.

As for kidney transplants, which are perhaps less dire than heart transplants thanks to dialysis, more than 70 people are waiting for kidneys at Sanford. On average, kidney recipients wait two to three years for a kidney. Only six live donors were found in the Sanford network in 2017, making Day part of an elite group.

Miller said while patients can live long, healthy lives on dialysis, it can be hard on a person's body. Since a working kidney works constantly to detoxify the blood, and dialysis is an intermittent and not constant filtration process, that means kidneys are more efficient and easier on organs like the heart. There is no expiration date for people on dialysis versus recipients of a donor kidney, but the leading cause of death for both parties is heart failure.

In addition, live donors have advantages over deceased donors.

"Living donors have to be in excellent health to donate a kidney," Miller said. "When we (perform) that surgery, the kidney usually starts functioning right away because there is very little time without blood supply. With a deceased owner, they are usually in ICU setting and maybe they have another medical condition. There is usually a traumatic event that leaves them with brain death and the kidney is removed and maybe needs to be shipped to another part of the country. It may be sleepy before it starts to function completely, but success rates are still very good with deceased donation."

Advantages or not, to Miller and professionals like her, donors are lifesavers whether living or dead. The supply is low and demand is high.

"They are giving the gift of life," Miller said.

Miller said 90 percent of adults support organ donation, but only 50 percent are registered donors. Deceased organ, tissue and eye donors can save or enhance the lives of more than 60 people, so it is important willing donors register and communicate with their loved ones about their wishes.

Living donors can affect many lives as well. Very healthy people can donate a kidney or part of their liver. Those who are eliminated for live organ donation (usually for sake of their own health) can often still contribute through other donation options, such as donating blood or plasma.

There is even a process of indirect kidney donation, called paired donation, when one person agrees to donate an organ to a stranger under the condition that someone else, usually someone they know, receives an organ in kind. Paired donation can form long chains as well, involving many donor/recipient agreements. This quid-pro-quo process actually helps to provide needed organs for many people, which is important given the rarity of donations.

"(The number of live donors) varies from year to year," Miller said. "I would say 15 (live) donors is a high number. Our goal is to do more each year. With paired donation, that possibility can help grow the numbers. People who are incompatible with each other can still donate through paired exchange."

Miller is an advocate for both live and deceased organ donation. She said there are some consequences of donation. For one, some medications metabolized in kidneys are discouraged following kidney donation, including popular non-steroidal anti-inflammatory drug pain relievers (liver metabolized pain relievers are still safe).

Donors are also urged to be careful to avoid traumatic damage to their remaining kidney, such as through violent sports. These consequences were worth it, in Day's opinion.

"I just say do it," Day said. "If you are healthy enough to give back, and you are able to and have people who would take care of you, I strongly suggest it. You feel good. I feel happy and I'm so happy he's doing well. He gets his life back. That's a pretty cool deal."