An unexpected tale of friendship amid paired organ donation

Molly Gray and Dan Napoleon are just two of a growing number donors and recipients who are increasing access to live organ transfers for minority community members.

Three doors down from her own hospital room, Molly Gray visited her friend Dan Napoleon, where they took selfies and live chatted with their kids’ soccer team, away at a tournament in Virginia.

Two days prior, Gray had been wheeled to an operating room, went under anesthesia, and gave away something priceless—one of her kidneys. The next day, Napoleon had received a brand-new kidney. It wasn’t from Gray, but it was a direct result of her altruism. And it was from a living rather than a deceased donor, making Napoleon a rarity among Black kidney recipients.

(Left) Molly Gray and Dan Napoleon in hospital gowns at HUP; right: Molly Gray and Dan Napoleon standing on a soccer field sideline.
Molly Gray and Dan Napoleon both recovered from transplant surgery a few rooms apart at the Hospital of the University of Pennsylvania, as part of a program called paired kidney donation. (Image: Penn Medicine News)

Paired donations and donation chains like these are expanding the supply of livers and kidneys from living donors. However, there are equity issues when it comes to this trend, as recipients from Black and other minority communities do not seem to have the same level of access to this second chance as their white counterparts often do.

Napoleon, 51, lives with his wife and children where he grew up, in Trenton, New Jersey. Gray, also 51, lives across the Delaware River in Yardley, Pennsylvania. Their paths crossed for the first time when Napoleon’s son Brandon and Gray’s son Cooper joined the same travel soccer team. For more than five years, the boys have played together, traveling to tournaments near and far, with their families cheering them on from the sidelines. But Napolean had severe health issues.

After battling hypertension and type 2 diabetes for years, he was referred to Penn Medicine. In 2018 Napoleon received a diagnosis of end-stage renal disease. He signed up for the transplant list, waiting for a deceased donor whose kidney was just the right match, and in the meantime had to endure four-hour dialysis sessions several days a week.In 2021, Napoleon posted an appeal on social media, looking for a living donor to give him a new kidney. Between his family, his fraternity network from college, and his church community, Napoleon’s request inspired dozens of offers to help.

Gray moved forward with the evaluation, but kept it a secret from Napoleon until she knew for sure she could donate. First she got good news: Her overall health and kidney condition made her an excellent candidate for donation. Then, the not-so-great news: Gray and Napoleon had different blood types, so she couldn’t donate directly to him.

However, the opportunity to participate in a “paired donation” emerged as a silver lining. Gray could donate to another patient that the National Kidney Registry (NKR) identified as compatible with her, while Napoleon could then receive his kidney from another living donor matched with him by the NKR.

“It doesn’t matter how old are you or your blood type, just that you are a healthy person and want to donate a kidney, the rest we will take care of,” remarks transplant surgeon Samir Abu-Gazala, Gray’s donor surgeon.

Since the paired donation, this pair has spent months recovering. They’re both back to work, and preparing for another busy travel soccer season. Gray’s recovery was swift, and Napoleon is getting good numbers in his follow-up tests. They are also teaming up to spread the word about living donation, and how desperately it’s needed among communities of color. Napoleon recalls the first time he walked into the dialysis clinic: “What immediately jumped out is that everyone looked like me—people of color.”

With so many Black people receiving kidneys from deceased donors—which have on average half the lifespan of those from living donors — Napoleon is grateful for his gift and adamant that he wants to raise awareness as well as recruit more donors. “A kidney’s a kidney, but living donations usually go to affluent white individuals, and deceased donors more often go to communities of color,” he observes. “We need to change that.”

Read more at Penn Medicine News.