Kim Chow says it was not a difficult decision to donate her kidney to a stranger knowing it meant her older sister, Stephanie Chow, would receive one in exchange.
asserted
sister → say → exchange
In late July, after months of testing and preparation, the sisters went under the knife in Edmonton’s University of Alberta Hospital.
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sisters → go → Hospital
Her kidney was removed, quickly placed on ice and airlifted to another province, completing one segment of a transplant chain that stretched across the country.
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that → remove → country
Five days later, another link was completed when Stephanie was wheeled into an operating room and received a kidney from a living donor outside of Alberta.
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Stephanie → complete → Alberta
She will never know who or where the organ came from.
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organ → know → where
The exchange was made possible through the Kidney Paired Donation Program run by Canadian Blood Services.
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exchange → make → Services
The program matches potential donor-recipient pairs who are incompatible with each other, such as the Chow sisters, with other such pairs across the country.
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who → match → country
Patients in need get a healthy kidney – just from a stranger instead of a friend or family member.
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Patients → get → stranger
Stephanie, 42, said the transplant has changed her life.
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transplant → say → life
Before the surgery, she had been on peritoneal dialysis, a treatment for kidney failure that uses the inner lining of the abdomen to filter blood inside the body.
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that → use → body
She was diagnosed with an autoimmune disorder as a child that attacked her kidneys until they “crapped out” about two years ago.
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they → diagnose → kidneys
“My life was very much determined by when I had to plug into the dialysis machine at night and what time I wanted to wake up.
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I → determine → time
I couldn’t really go anywhere or travel anywhere because the machine I would have to carry, the supplies, is in abundance,” Stephanie said.
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Stephanie → go → abundance
She continued: “This kidney is now giving me more flexibility.
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kidney → continue → flexibility
I feel like I have my life back.”
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I → feel → life
In 2025, nearly 3,200 organs were transplanted in Canada, 59 per cent of which were kidneys, according to data from the Canadian Institute for Health Information.
uncertain
cent → transplant → Information
The majority of transplants use organs from deceased donors, since a single body can provide multiple organs.
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body → use → organs
Living donors can only safely give specific organs, such as one of their two kidneys, and must pass strict medical and psychological evaluations.
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donors → live → evaluations
Stephanie is thankful for being part of the exchange program, not only because it cut down her wait time for a transplant, but because a kidney from a living donor lasts longer and generally provides better outcomes.
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kidney → cut → outcomes
The sisters want to raise greater awareness about the program, hoping to help others in Stephanie’s position.
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sisters → want → position
“A lot of people have no idea this is an option,” she said.
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she → have → idea
The paired donation program offers three possible chains, explained transplant nephrologist Michel Paquet, who is a medical adviser to Canadian Blood Services.
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who → pair → Services
The first is a paired exchange, where two donor-recipient pairs, or four people, swap kidneys.
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pairs → pair → kidneys
Then there is a “closed chain,” where the exchange happens between three or more pairs, usually maxing out at seven, and where the final donor gives a kidney to the first recipient, closing a self-contained loop.
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donor → be → loop
Finally, there is an “open chain,” where a sequence of transplants is sparked by an altruistic person who donates a kidney but is not connected to a transplant candidate.
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who → be → candidate
Chains are created using a computerized algorithm and there are three match cycles each year, said Dr. Paquet, who is also the medical director of the living kidney donation program at the University of Montreal Hospital Centre.
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who → create → Centre
Since the program began in 2009 – first in Alberta, British Columbia and Ontario before expanding across Canada – it has led to more than 1,300 transplants, he added.
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he → begin → transplants
For the first decade, donors had to travel to the recipient’s city to have the surgery.
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donors → have → surgery
But COVID-19 pushed the program to transport the organs between cities and provinces, helping to expand its reach.
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COVID-19 → push → reach
More than 400 organs have since been shipped across the country.
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organs → ship → country
One challenge with the program is that the chains are fragile and can collapse if even one person can no longer donate or receive a kidney.
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person → collapse → kidney
However, Dr. Paquet said it’s “pretty rare” for people to simply back out.
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people → say → ?
When that does happen, it’s more often related to medical issues.
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it → happen → issues
Kim, 38, described the program as an exercise in humanity, where emotions are tangled into every decision of an emotionally and physically taxing process.
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emotions → describe → process
She began her journey to become a donor in spring 2024, undergoing countless tests – including blood work, urine samples, physical exams, medical questionnaires, X-rays and CT scans – before the surgery took place this summer.
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surgery → begin → place
Kim was told that at any point she could back out.
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she → tell → point
“As a family member, you want to do everything within your power to help your loved one, right?
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you → want → one
So, even if for whatever reason things didn’t work out, I wanted to know that I had done everything that I could do to help her in that situation.”
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I → work → situation
Kim did have some worries, such as the long-term impact of having only one kidney and how difficult recovery would be, but none were big enough to sway her from helping her sister.
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none → have → sister
Postsurgery, their experiences have differed greatly.
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experiences → differ → ?
…and 9 more, not listed.
The Aporia
