For Maureen Rush, a kidney transplant wasn’t always something she anticipated needing. That all changed, following an unexpected kidney disease diagnosis. When her condition worsened, her husband, Graham, didn’t hesitate—he offered to donate. But his willingness alone wasn’t enough. When testing showed they weren’t a compatible match, the couple turned to Kingston Health Sciences Centre (KHSC), home to the region’s only program performing living kidney transplants, they found another path forward through a lesser-known option: a list exchange donation.
From unexpected diagnosis to kidney failure
Maureen was living overseas in Dubai when she was first diagnosed with polycystic kidney disease (PKD) after an ultrasound revealed cysts on her kidneys.
I was in my early 50s when I found out. It came as a shock to me, since I’d been feeling healthy. Up to that point I’d lived a very healthy lifestyle. Part of the shock was that I have no known relatives with kidney disease.
PKD presents differently for everyone. For several years, Maureen was able to manage it with lifestyle changes, but that changed around 2015 after returning to Canada:
“I went to urgent care for something unrelated, and they suggested I see a nephrologist. That brought me to KHSC. I’ve been followed by various clinics in the program for about 11 years.”
Over time, her kidney function declined gradually. Around 2021, her filtration rate—a key measure of kidney function—began to drop steadily and she started dialysis in 2025.
“The decision to explore a kidney transplant actually came six months before starting dialysis,” explains Maureen. “I hoped that the transplant would happen before I needed to go on dialysis, but that’s not what happened. The hardest part wasn’t dialysis—it was the waiting after I completed my transplant workup,” explained Maureen. “The workup process gave me something to focus on. But once it was done, I had no control.”
A willing donor, but not a match
Maureen and Graham have been married for over 50 years. When the question of donation came up, his answer was immediate: he would step forward.
He was eventually approved as a donor but, because his kidney wasn’t compatible, he couldn’t donate directly to Maureen.
“When we found out we weren’t compatible, I still wanted to help,” says Graham. “That meant donating to someone else so Maureen could receive a kidney in return.”
The first option was a kidney paired donation: he would donate to a recipient whose donor would, in turn, donate to Maureen.
“We went through multiple matching cycles without success,” explained Graham.
Then one of the transplant coordinators called and said, ‘you know, I think we've got another idea: what about the list exchange?’ That changed everything.
Kidney donation can help someone you’ve never met
There are two main pathways to kidney transplant: receiving a kidney from a deceased donor, or from a living donor.
The deceased donor system functions like a waitlist. Patients are assessed by the transplant program and then wait for a kidney to become available from a registered donor. Because only about a third of Canadians are registered organ donors, wait times can be long.
Living donation offers another path forward. In some cases, a donor can give directly to someone they know,or give anonymously to someone they don't. In others, programs like kidney paired donation match donors and recipients across different pairs to find compatible combinations, often shortening wait times.
A list exchange is a rare option, used in specific circumstances, that combines these two ideas. In Graham’s case, he chose to donate anonymously to someone on the deceased donor waitlist. In return, Maureen was able to receive a kidney from a deceased donor.
This process depends on someone being willing to donate to a stranger—a personal decision not everyone is comfortable making.
Maureen’s transplant was the first list exchange ever completed at KHSC—an approach so uncommon it has been used only in a small number of cases across the province.”
“Some people offered to donate, but only directly to me—they weren’t comfortable donating anonymously,” noted Maureen. “That’s something people struggle with.”
Graham had a different perspective.
For me, it felt straightforward. There’s a deep satisfaction in helping someone. The idea of donating to a stranger didn’t bother me. I trusted the system. If they said someone would benefit, that was enough.
Supported every step of the way
Maureen and Graham say they received incredible support from their care team throughout the transplant process.
“The care team was outstanding—clear communication, responsive follow-up, and strong support throughout the entire process.”
For Maureen, waiting remained the most difficult part.
“Finally, a suitable kidney became available." recalled Mureen. "The transplant went well, and the kidney started working immediately.”
Graham noticed the difference right away.
“Watching Maureen decline was difficult. But after the transplant, seeing her regain her energy—it was immediate. That was the moment everything felt worth it.”
The Kingston Kidney Transplant Program (KKTP), part of KHSC’s Regional Renal Program, supports patients at every stage of the transplant journey—from initial assessment through to surgery and follow-up care. At any given time, approximately 75 patients are undergoing evaluation to determine their eligibility for a kidney transplant.
In addition to directed donations facilitated by KKTP, individuals can participate in the Kidney Paired Donation Program, coordinated by Canadian Blood Services, which matches donors and recipients across Canada to increase transplant opportunities.
The program serves a broad geographic region, with patients coming not only from Kingston and surrounding communities, but from areas spanning Cobourg to Smiths Falls and as far north as Attawapiskat. For many, accessing care closer to home reduces the burden of travel while keeping them connected to specialized transplant services.
Last year the program completed 13 deceased donor transplants, nine living donor transplants, and 11 living kidney donations. The program continues to surpass their target of five living donations per-year—reflecting both the demand for transplant and the willingness of donors to come forward.
What donation makes possible
“It’s a long and challenging journey,” says Maureen, reflecting on her transplant experience.
It involves not just you, but your whole support system—family, friends, healthcare teams. You don’t realize how many people are involved until you go through it.
For Graham, donating anonymously was a unique experience.
“The sense of contribution is profound, and the process is safe and well-managed. And knowing it helped not just Maureen but another person—that’s incredibly meaningful.”
Whether through signing up as an organ donor, participating in living donation, or alternative options like paired and list exchanges, each offers hope in different ways. What connects them all is the profound impact donors can make, helping to shorten wait times and, in many cases, save lives.
